JP2009202016A - 椎間板プロテーゼ - Google Patents

椎間板プロテーゼ Download PDF

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Publication number
JP2009202016A
JP2009202016A JP2009142968A JP2009142968A JP2009202016A JP 2009202016 A JP2009202016 A JP 2009202016A JP 2009142968 A JP2009142968 A JP 2009142968A JP 2009142968 A JP2009142968 A JP 2009142968A JP 2009202016 A JP2009202016 A JP 2009202016A
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Prior art keywords
core
lower plate
intervertebral disc
plate
disc prosthesis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
JP2009142968A
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English (en)
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JP5584432B2 (ja )
Inventor
Jacques Beaurin
Thierry Dufour
Jean-Marc Fuentes
Jean Huppert
Jean-Marc Vital
ジヤツク・ボーラン
ジヤン−マルク・ビタル
ジヤン−マルク・フユアント
ジヤン・ウツペール
チエリ・ドユフール
Original Assignee
Ldr Medical
エル・デ・エール・メデイカル
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61B17/0642Surgical staples, i.e. penetrating the tissue for bones, e.g. for osteosynthesis or connecting tendon to bone
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    • A61F2002/443Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008Fixation appliances for connecting prostheses to the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008Fixation appliances for connecting prostheses to the body
    • A61F2220/0016Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • AHUMAN NECESSITIES
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0041Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws

Abstract

【課題】プロテーゼの種々の構成部分の互いに対する動きを制限することを可能にする、単純な椎間板プロテーゼを提案する。
【解決手段】上部プレート1と、下部プレート2と、コア3とを含み、コア3の上面が、上部プレート1の下面の少なくとも一部10に接触し、コア3の下面が、下部プレート2の上面の少なくとも一部に接触し、下部プレート1が、少なくともコア3に対して移動可能であり、下部プレート2に実質的に平行な軸に沿った下部プレート2に対するコア3の並進運動を制限しまたは無くすように、かつ下部プレート2に実質的に垂直な軸を中心とする下部プレート2に対するコア3の回転運動を制限しまたは無くすように、下部プレート2とコア3との間に協働手段があり、上部1および下部2プレートを通過する平面が、実質的に一定の角度を形成することを特徴とする、椎間板プロテーゼによって達成される。
【選択図】図4a

Description

本発明は、脊柱の椎骨、特に頚椎の椎骨を連結する線維軟骨板の代用を目的とする、椎間板プロテーゼに関する。

様々なタイプのプロテーゼが、従来技術では知られている。これらのプロテーゼのいくつかは、それらが圧縮性の材料で作製されているので、またはプロテーゼの種々の構成部分が互いに対して過剰に動くことができるので、プロテーゼの少なくとも一部が比較的容易に椎骨から外へと突き出されることがあり、これは患者にとって望ましくないことである。

本発明の目的は、プロテーゼの種々の構成部分の互いに対する動きを制限することを可能にする、単純な椎間板プロテーゼを提案することによって、従来技術のいくつかの欠点を改めることである。

この目的は、上部プレートと呼ばれる第1のプレートと、下部プレートと呼ばれる第2のプレートと、コアとを含んだ少なくとも3つの部分を含み、コアの上面が、上部プレートの下面の少なくとも一部に接触し、コアの下面が、下部プレートの上面の少なくとも一部に接触し、下部プレートが、少なくともコアに対して移動可能である椎間板プロテーゼであって、下部プレートに実質的に平行な軸に沿った下部プレートに対するコアの並進運動を制限しまたは無くすように、かつ下部プレートに実質的に垂直な軸を中心とする下部プレートに対するコアの回転運動を制限しまたは無くすように、下部プレートとコアとの間に協働手段があり、上部プレートを通過する平面と下部プレートを通過する平面が、実質的に一定の角度を形成することを特徴とする、椎間板プロテーゼによって達成される。

別の特徴によれば、下部プレートは、コアの雌手段と協働する雄手段を含む。

別の特徴によれば、下部プレートは、コアの雄手段と協働する雌手段を含む。

別の特徴によれば、角度は、コアが前後方向に鋭角を形成することによって得られる。

別の特徴によれば、同様のプレートを、異なる厚さのコアとともに組み立てることができる。

別の特徴によれば、上部プレートと下部プレートとの間の角度は、0°から15°の間である。

別の特徴によれば、コアは、上部および/または下部プレートに対して移動可能であり、それによって、プロテーゼの3つの部分の互いに対する位置決め不良を補償することが可能になる。

別の特徴によれば、上部プレートの下面の少なくとも一部は、窪んでおり、コアの上面に対して相補的なものである。

別の特徴によれば、各雄手段の寸法は、コアと下部プレートとの間にわずかな隙間ができるように、各雌手段の寸法よりもわずかに小さい。

別の特徴によれば、各雄手段の寸法は、コアと下部プレートとの間に隙間が少しも生じないように、各雌手段の寸法と実質的に同じである。

別の特徴によれば、下部プレートの雄手段は、プロテーゼの内側に向かって湾曲し、かつプロテーゼの2つの縁部上で互いに反対側に位置付けられた2個のピンであり、コアの雌手段は、2個の凹部である。

別の特徴によれば、ピンの少なくとも一方は、穿孔部を備えたラグと置き換えられ、タグが、この穿孔部に入るだぼ(dowel)を使用して固定されるものである。

別の特徴によれば、下部プレートの雄手段は、下部プレートの中心付近に位置付けられた2個のだぼピンであり、コアの雌手段は、2個のウェルである。

別の特徴によれば、下部プレートの雄手段は、プロテーゼの2つ縁部付近で互いに反対側に位置付けられた2つの壁部であり、コアの雌手段は、凹部である。

別の特徴によれば、下部プレートの雄手段は、プロテーゼの中心に位置付けられたリブであり、コアの雌手段は、溝である。

別の特徴によれば、コアは、ポリエチレンで作製される。

別の特徴によれば、下部プレートは、その正面付近に、プロテーゼ固着手段を椎骨で受容するよう設けられた1つまたは複数の開口を含む。

別の特徴によれば、下部プレートの開口は、長方形であり、固着手段は、下部プレートに対して鋭角を形成する本体と、ヘッドとからなる。

別の特徴によれば、下部プレートの開口は、円形であり、固着手段は、釘形状である。

別の特徴によれば、上部プレートは、椎骨の形状に合うようにその上面の少なくとも一部が凸状である。

本発明のその他の特徴および利点は、添付図面を参照しながら以下の記述を読むことによって明らかにされよう。

一実施形態による上部プレートを示す下面図である。 一実施形態による上部プレートを示す斜視下面図である。 一実施形態による下部プレートを示す平面図である。 一実施形態による下部プレートを示す斜視平面図である。 一実施形態によるコアを示す平面図である。 一実施形態によるコアを示す斜視平面図である。 図1a、図1b、図2a、図2b、図3a、および図3bの実施形態による椎間板プロテーゼを示す斜視平面図である。 図1a、図1b、図2a、図2b、図3a、および図3bの実施形態による椎間板プロテーゼを示す側面図である。 第2の実施形態による椎間板プロテーゼを示す側面図である。 第2の実施形態による椎間板プロテーゼを示す、図5aの平面D−Dに沿った断面図である。 第3の実施形態による椎間板プロテーゼを示す側面図である。 図6aの平面A−Aに沿った断面図であり、コアが、下部プレートに対してわずかな隙間を有する状態を示す図である。 椎間板プロテーゼを示す、図6bの平面B−Bに沿った断面図である。 図6aの平面A−Aに沿った断面図であり、コアが、下部プレートに対して全く隙間を持たない状態を示す図である。 椎間板プロテーゼを示す、図6dの平面B−Bに沿った断面図である。 その他の実施形態による下部プレートを示す平面図である。 異なる実施形態によりプロテーゼ固着手段が挿入された、図7aの下部プレートを示す斜視側面図である。 その他の実施形態による下部プレートを示す斜視下面図である。 異なる実施形態によりプロテーゼ固着手段が挿入された、図8aの下部プレートを示す斜視平面図である。 第4の実施形態による下部プレートを示す平面図である。 図9aの平面C−Cに沿った下部プレートを示す断面図である。 別の実施形態による上部プレートを示す背面図である。 別の実施形態による上部プレートを示す側面図である。

本発明による椎間板プロテーゼは、図4a、図4b、図5a、および図6aに特に見られるように、コア3によって下部プレート2に連接された上部プレート1から構成される。本発明によるプロテーゼの1つの利点は、プロテーゼが頚椎に取り付けられるように構成することができる単純な部品を含むことである。

図1aおよび図1bで特に見られる上部プレート1は、その下面の少なくとも一部10が、コア3のわずかに凸状をなす上面に合うように、わずかに窪んでいる。コア3の上面は、上部プレート1の凹部10と相補的であり、上部プレート1とコア3との間での動きが可能になる。

代替の実施形態では、図10aおよび図10bに示すように、プロテーゼを取り付ける椎骨により良く適合させるため、上部プレート1の上面の一部が、凸状になっており、この椎骨の底面は窪んでいる。この場合、上部プレート1の凸状部分は、図10bに特に見られるように、上部プレートの前部に位置付けされる。

下部プレート2は実質的に平面である。事実上下部プレート2の下面は、椎骨の最上部が実質的に平らであるので、凸状または凹状である必要はない。図2a、図2b、図7a、および図8aの実施形態では、下部プレート2は、下部プレート2の実質的に平行な2つの縁部21、22で互いに反対側に位置付けられた2つのピン20を含む。各ピン20は、プロテーゼの内側に向かって湾曲し、したがってコア3上に位置付けられた凹部30に入ることができる。図3aおよび図3bで特に見られるコア3は、下部プレート2に取り付けられるよう設けられた実質的に平面である下面を含む。コア3は、頚部プロテーゼでは薄く(例えば3mmの厚さ)、腰部プロテーゼではより厚い(例えば15mm)。

図3a、図3b、図4a、および図4bの実施形態では、下部プレート2に実質的に平行な軸に沿った並進と、下部プレート2に実質的に垂直な軸を中心とした回転との両方において、下部プレート2に対するコア3の隙間が制限されるように、コア3の各凹部30の寸法が、下部プレート2の各ピン20の寸法よりわずかに大きくなっている。したがって上部プレート1とコア3との間の動きならびに下部プレート2に対するコア3の隙間によって、患者は動くことが可能になり、必要に応じてプロテーゼの位置決め不良を補償することが可能になる。この隙間は、プロテーゼに加えられる応力に起因した時期尚早の摩耗の防止ももたらす。

図5aおよび図5bの実施形態では、並進と回転の両方において下部プレート2に対するコア3の隙間が少しも生じないように、コア3の各凹部30の寸法が、下部プレート2の各ピン20の寸法と実質的に同じになっている。後者の場合、認められたプロテーゼの唯一の動きは、コア3に対する上部プレート1の動きである。 図9aおよび図9bの実施形態では、ピン20の一方を、穿孔部200を備えたラグと置き換える。タグ23は、穿孔部200に入るだぼ24を用いてラグに固定する。代替の実施形態では、両方のピンを、表面にタグ23が固定されるラグと置き換える。

図6a、図6b、図6c、図6d、および図6eの実施形態では、下部プレート2は、いかなるピン20も含まず、下部プレート2の中心付近に位置付けられた2つのだぼピン25を含む。この場合コア3は、相補的にいかなる凹部30も含まず、その下面の下側に2つのウェル35を含む。下部プレート2のだぼピン25の寸法とコア3のウェル35の寸法は、図6bおよび図6cに示す代替の実施形態において、並進および回転でわずかな隙間が可能になるようなものであり、また図6dおよび図6eに示す代替の実施形態では、隙間が生じないようなものである。

図示されない別の実施形態で、下部プレート2は、その上面にリブを含み、ピン20もだぼピン25も含まない。コア3は、相補的に、その下面の下側に溝を含む。下部プレートのリブの寸法とコアの溝の寸法は、ある代替の実施形態では、並進および回転でわずかな隙間ができるようなものであり、また別の実施形態では、隙間ができないようなものである。

図示されない別の実施形態で、下部プレート2は、ピン20の代わりに、下部プレートの実質的に平行な2つの縁部21、22付近であるがピン20以外のプロテーゼ内に互いに反対側に配置された2つの壁部を含む。コア3は、壁部に対して相補的な凹部を含む。この実施形態におけるコアの各凹部の寸法は、並進および回転でわずかな隙間ができるようにまたはできないように、下部プレートの各壁部の寸法よりもわずかに大きいかまたは実質的に同じである。

図示されない他の実施形態では、雌構成要素が、下部プレートに位置付けられ、雄構成要素がコアに位置付けられる。

本発明による椎間板プロテーゼは、特に、例えば頚椎などの、脊椎前彎異常の矯正を可能にし、また脊椎の前彎を増大させる。したがって、プロテーゼの上部プレート1と下部プレート2との間で、図4bの前後方向Fに鋭角が存在することが必要である。例えばこの角度は、0°から15°の間である。患者に必要とされる角度を調節するには、コア3の上面に相当する平均平面とコア3の下面を通過する平面とが適切な角度をなしているコア3を選択するだけでよい。

雌構成要素が下部プレートに位置付けられ、かつ雄構成要素がコアに位置付けられている場合、脊椎前彎コアは、前後方向に鋭角を形成するので、下部プレートの空洞または開口に入る突起部によってプレートと一体化することができる。

従来技術で知られているプロテーゼの傾斜は、コアが平らなときは上部プレートの形状によって、前記コアが凸状であるときはコアに対する上部プレートの位置によって得られる。本明細書で述べた従来技術の第1の場合に対し、本発明によるプロテーゼの機械加工は、コアがプレートを構成する材料よりも安価な材料(例えばポリエチレン)で構成されているので、より経済的である。本明細書で述べた従来技術の第2の場合に対し、本発明のコアは、プロテーゼが所定の位置にあるときには、プレート間の角度が実質的に一定であるので、プロテーゼの外側に突き出されにくい。

外科医がある患者に対して確定的な脊椎前彎を必要とする場合、外科医は、下部プレート2に対して隙間をもたらさないコア3を選択することになる。一方、外科医が、ある範囲内の値でのみ脊椎前彎を維持すればよい場合には、外科医は、下部プレート2に対して並進および回転の際にわずかな隙間をもたらすコアを選択することになる。

本発明による椎間板プロテーゼは、図7a、図7b、図8a、および図8bに示されるある代替の実施形態において、前彎と共に増大する所定位置のプロテーゼに対して、脊柱から加えられた力の横方向の合力の作用の下、プロテーゼが移動しないように、脊柱に固着することができる。この場合、下部プレート2は、プロテーゼの背面付近に位置付けられた1つまたは複数の開口28、29を含み、固着手段4、5を受容することが可能になる。

このように図7aおよび図7bの場合、下部プレート2の開口28は長方形であり、固着手段4は、本体40およびヘッド41から構成される。ヘッド41の寸法は、下部プレート2の開口28の寸法よりもわずかに大きく、したがって固着手段4が椎骨の所定位置に入ると、下部プレート2が、固着手段4のヘッド41と前記椎骨との間に挟まれるようになされている。90°以下の角度は、固着手段4の本体と下部プレート2との間で構成される。

図8aおよび図8bの場合、2つの円形開口29が下部プレート2に含まれ、固着手段5は釘形状であり、その頭部は開口29の寸法よりも大きく、固着手段5の頭部と表面にプロテーゼが固着される椎骨との間に下部プレート2を挟むことが可能になる。

本発明によれば、特許請求の範囲に記載される本発明の範囲から逸脱することなく、数多くのその他の特定の形態をとる実施形態が可能になることが、当業者には明らかであろう。その結果、本発明の実施形態を例示と見なさなくてはならないが、特許請求の範囲によって規定された領域内で変更を加えることができ、本発明を上記所与の詳細事項に限定してはならない。

Claims (20)

  1. 上部プレート(1)と呼ばれる第1のプレートと、下部プレート(2)と呼ばれる第2のプレートと、コア(3)とを含んだ少なくとも3つの部分を含み、コア(3)の上面が、上部プレート(1)の下面の少なくとも一部(10)に接触し、コア(3)の下面が、下部プレート(2)の上面の少なくとも一部に接触し、上部プレート(1)が、少なくともコア(3)に対して移動可能である椎間板プロテーゼであって、下部プレート(2)に実質的に平行な軸に沿った下部プレート(2)に対するコア(3)の並進運動を制限しまたは無くすように、かつ下部プレート(2)に実質的に垂直な軸を中心とする下部プレート(2)に対するコア(3)の回転運動を制限しまたは無くすように、下部プレート(2)とコア(3)との間に協働手段があり、上部(1)および下部(2)プレートを通過する平面が、実質的に一定の角度を形成することを特徴とする椎間板プロテーゼ。
  2. 下部プレート(2)が、コア(3)の雌手段と協働する雄手段を含むことを特徴とする、請求項1に記載の椎間板プロテーゼ。
  3. 下部プレート(2)が、コア(3)の雄手段と協働する雌手段を含むことを特徴とする、請求項1に記載の椎間板プロテーゼ。
  4. コア(3)が前後方向(F)に鋭角を形成することにより、角度が得られることを特徴とする、請求項1から3のいずれか一項に記載の椎間板プロテーゼ。
  5. 同じプレート(1、2)を異なる厚さのコア(3)と組み立てることができることを特徴とする、請求項4に記載の椎間板プロテーゼ。
  6. 上部プレート(1)と下部プレート(2)との角度が、0°から15°の間であることを特徴とする、請求項4または5のいずれか一項に記載の椎間板プロテーゼ。
  7. コア(3)が上部(1)および/または下部(2)プレートに対して移動可能であり、プロテーゼの3つの部分(1、2、3)の互いに対する位置決め不良を補償することが可能になることを特徴とする、請求項1から6のいずれか一項に記載の椎間板プロテーゼ。
  8. 上部プレート(1)の下面の少なくとも一部(10)が、窪んでおり、コア(3)の上面(31)と相補的であることを特徴とする、請求項1から7のいずれか一項に記載の椎間板プロテーゼ。
  9. 各雄手段の寸法が、コア(3)と下部プレート(2)との間にわずかな隙間ができるように、各雌手段の寸法よりもわずかに小さいことを特徴とする、請求項1から8のいずれか一項に記載の椎間板プロテーゼ。
  10. 各雄手段の寸法が、コア(3)と下部プレート(2)との間に隙間が少しもないように、各雌手段の寸法と実質的に同じであることを特徴とする、請求項1から8のいずれか一項に記載の椎間板プロテーゼ。
  11. 下部プレート(2)の雄手段が、プロテーゼの内側に向かって湾曲されかつプロテーゼの2つの縁部(21、22)で互いに反対側に位置付けられた2つのピン(20)であり、コア(3)の雌手段が、2つの凹部(30)であることを特徴とする、請求項2および4から10のいずれか一項に記載の椎間板プロテーゼ。
  12. ピン(20)の少なくとも一方が、穿孔部(200)を備えたラグと置き換えられ、タグ(23)が、穿孔部(200)に入るだぼ(24)を使用することを特徴とする、請求項11に記載の椎間板プロテーゼ。
  13. 下部プレート(2)の雄手段が、下部プレート(2)の中心付近に位置付けられた2つのダボピン(25)であり、コア(3)の雌手段が、2つのウェル(35)であることを特徴とする、請求項2および4から10のいずれか一項に記載の椎間板プロテーゼ。
  14. 下部プレート(2)の雄手段が、プロテーゼの2つの縁部(21、22)付近に互いに反対側に位置付けられた2つの壁部であり、コア(3)の雌手段が、凹部であることを特徴とする、請求項2および4から10のいずれか一項に記載の椎間板プロテーゼ。
  15. 下部プレート(2)の雄手段が、プロテーゼの中心に位置付けられたリブであり、コア(3)の雌手段が、溝であることを特徴とする、請求項2および4から10のいずれか一項に記載の椎間板プロテーゼ。
  16. コア(3)がポリエチレン製であることを特徴とする、請求項1から15のいずれか一項に記載の椎間板プロテーゼ。
  17. 下部プレート(2)が、正面付近に、プロテーゼ固着手段(4、5)を椎骨で受容するよう設けられた1つまたは複数の開口(28、29)を含むことを特徴とする、請求項1から16のいずれか一項に記載の椎間板プロテーゼ。
  18. 下部プレート(2)の開口(28)が長方形であり、固着手段(4)が、下部プレート(2)と鋭角を形成する本体(40)およびヘッド(41)からなることを特徴とする、請求項17に記載の椎間板プロテーゼ。
  19. 下部プレート(2)の開口(29)が円形であり、固着手段(5)が釘形状であることを特徴とする、請求項17に記載の椎間板プロテーゼ。
  20. 上部プレート(1)の上面の少なくとも一部が、椎骨の形状に合うように凸状であることを特徴とする、請求項1から19のいずれか一項に記載の椎間板プロテーゼ。
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