CN101232851A - 脊柱稳定的椎间假体装置及其植入方法 - Google Patents

脊柱稳定的椎间假体装置及其植入方法 Download PDF

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CN101232851A
CN101232851A CNA2006800278059A CN200680027805A CN101232851A CN 101232851 A CN101232851 A CN 101232851A CN A2006800278059 A CNA2006800278059 A CN A2006800278059A CN 200680027805 A CN200680027805 A CN 200680027805A CN 101232851 A CN101232851 A CN 101232851A
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A·布鲁钮
T·A·卡利斯
E·C·朗恩
F·J·莫利兹四世
M·M·莫里森
J·M·德威利
K·M·安德森
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Warsaw Orthopedic Inc
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Warsaw Orthopedic Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices

Abstract

一种假体装置及其插入相邻椎骨间的方法，由此提供两个连接的构件，其中之一由相对柔性材料形成，另一个由相对刚性材料形成。

Description

脊柱稳定的椎间假体装置及其植入方法
技术领域
本发明涉及用于稳定人体脊柱的椎间假体装置及其植入方法。
背景技术
人体脊柱中相邻椎骨间延伸的椎间盘提供了相邻椎骨间的关键支撑。这些盘可能因为损伤、退化、疾病等情况而发生一定程度的破裂、变性和/或突出，导致由于盘丧失至少一部分支撑功能，相邻椎骨间的椎间隙陷落，引起神经根冲击和严重疼痛。
在这些情况下，设计了椎间假体装置，可在脊柱前侧和后侧植入相邻椎骨之间，以防止相邻椎骨间的椎间隙陷落，从而稳定脊柱。
然而，许多这些装置相对刚性，因而不能挠曲以更好地适应椎骨并且不能提供足够程度的变形性。而且，许多这些装置一旦植入存在相对较高疲劳度的问题。
发明内容
根据本发明实施方式的椎间假体装置通过提供相对较低疲劳特征和相对较高变形性而克服了上述缺陷，产生与解剖学结构的优良匹配。本发明各种实施方式可具有一个或多个上述特征和优点，或者提供一种或多种解决现有技术存在的上述问题的办法。
附图说明
图1是成人脊柱的侧视图。
图2是图1所示脊柱的后视图。
图3是图1和2所示脊柱椎骨之一的放大前视图。
图4是图1和2所示脊柱的一部分的部分放大等角视图，包括三个较低位椎骨，描绘了根据本发明实施方式的椎间假体装置插入两个相邻椎骨之间。
图5是图3所示假体装置的放大等角分解视图。
图6和7是图5所示可选实施方式的假体装置的放大等角分解视图。
具体实施方式
参考图1和2、通常参考标号10表示人体脊柱10。显示了脊柱10的低位部分，包括腰椎区域12、骶骨14和尾骨16。未显示脊柱10的可弯曲柔软部分，包括胸椎区域和颈椎区域。
脊柱10的腰椎区域12包括五个由椎间盘D1、D2、D3和D4分隔的椎骨V1、V2、V3、V4和V5，盘D1在椎骨V1和V2间延伸，盘D2在椎骨V2和V3间延伸，盘D3在椎骨V3和V4间延伸，盘D4在椎骨V4和V5间延伸。
骶骨14包括五个融合椎骨，其中之一是由盘D5与椎骨V5分隔的上椎骨V6。骶骨14的其余四个融合椎骨共同称为V7。盘D6分隔骶骨14与尾骨16，尾骨16包括四个融合椎骨(未示出)。
参考图3，椎骨V4包括在棘突22两侧延伸的两个椎板20a和20b(如图2所示)，棘突22从两个椎板的连接处向后伸出。两个横突24a和24b分别从椎板20a和20b侧向伸出，两个椎弓根26a和26b分别从突起24a和24b向下延伸至椎体28。由于其它椎骨V1-V3和V5与椎骨V4相似，将不再详细描述。
参考图4，假定出于上述一种或多种原因，椎骨V4和V5没能得到盘D4的足够支撑，因而需要向这些椎骨提供附加的支持和稳定。为此，将根据本发明实施方式的椎间盘假体装置40植入椎骨V4和V5的棘突22之间。
装置40在图5中详细显示，包括大致矩形的主体元件42，只是在一端形成弯曲凹口42a。还提供大致矩形的主体元件44，只是在一端形成弯曲凹口44a。
提供用于连接主体元件的机构，包括连接件46，它被设计成能够分别套接匹配在从主体元件42和44延伸的两个连接元件42b和44b上。为此，连接件46具有通孔46a，其截面稍大于元件42b和44b的截面。
为了连接主体元件42和44，将元件42b和44b从通孔相对端插入开口46a直到主体元件42和44的对应肩部与连接件46的对应端相啮合。
优选地，主体元件42和44由相对柔性、柔软的材料制成，连接件则由相对刚性材料制成。
当装置40植入两个相邻椎骨V4和V5之间时(图4)，椎骨V4或V5之一的棘突22分别伸入凹口42a，另一椎骨的棘突伸入凹口44a，或相反。相对柔性的柔软主体元件42和44提供优良的变形性以改善匹配度，连接件46则为装置40增加刚性、压缩强度和耐久性。
应理解，外科医生可备有多个不同刚性的连接件46。因此，一旦外科医生确定了椎骨V4和V5的状态(图4)并确定了所需的具体刚性，即可选择合适的连接件46。
根据另一实施方式的假体装置50在图6中详细显示，包括基本上矩形的主体元件52，只是在一端形成弯曲凹口52a。还提供了主体元件54，它被设计成连接于主体元件52。主体元件54大致为矩形，只是在一端形成弯曲凹口54a。
提供一连接主体元件52和54的机构，包括从主体元件54另一端伸出的连接元件54a和主体元件52另一端处形成的矩形开口52b。元件54a的尺寸稍小于开口52a的对应尺寸。通过将元件54b插入开口52b中直到主体元件的对应面相互毗邻来实现主体元件52和54的连接。
主体元件52和54中的一个由相对柔性、柔软的材料制成，另一主体元件由相对刚性的材料制成。为了示例的目的，假定主体元件52由相对柔性、柔软的材料制成而主体元件54由相对刚性的材料制成。
当装置50植入两个相邻椎骨V4和V5之间时(图4)，椎骨V4或V5之一的棘突22伸入主体元件52的凹口52a中，而另一椎骨的棘突22则伸入主体元件52的凹口54a中。相对柔性、柔软的主体元件52提供优良的变形性以改善匹配度，而主体元件54则为装置50增加刚性、压缩强度和耐久性。
应理解，外科医生可备有多个不同刚性的主体元件54。因此，一旦外科医生确定了椎骨V4和V5的状态(图4)并确定了所需的具体刚性，即可选择合适的主体元件54。
根据另一实施方式的假体装置60在图7中详细显示，包括两个主体元件62和64。主体元件62和64大致为矩形，只是分别在主体元件的一端形成弯曲凹口62a和64a。
提供一连接主体元件62和64的机构66，包括厚度基本对应于主体元件62和64的厚度的矩形基部66a。两个连接元件66b和66c分别从基部66的相对面伸出。
主体元件62的另一端中形成一矩形开口62b，主体元件64的另一端也形成矩形开口(未示出)。
连接元件66b和66c的尺寸稍小于主体元件62中的开口62b和主体元件64中的开口(未示出)的尺寸。
因而连接件66的元件66b可插入主体元件62的开口62b中直到连接件与主体元件的对应面相互毗邻。类似地，连接件66的元件66c可插入主体元件64的上述开口中直到连接件与主体元件的对应面相互毗邻。
主体元件62和64可由相对柔性、柔软的材料制成，而连接件66则由相对刚性的材料如金属或塑料制成。
当装置60插入两个相邻椎骨V4和V5之间时(图4)，椎骨V4或V5中的一个的棘突22伸入主体元件62的凹口62a中，而另一椎骨的棘突22则伸入主体元件64的凹口64a。相对柔性、柔软的主体元件62和64提供优良的变形性以改善匹配度，连接件66则为装置60增加刚性、压缩强度和耐久性。
应理解，外科医生可备有多个不同刚性的机构66。因此，一旦外科医生确定了椎骨V4和V5的状态(图4)并确定了所需的具体刚性，即可选择合适的机构66。
应理解，在图5和7的实施方式中，构成主体元件42、44、62和64的材料可以是柔性软塑料如硅；而连接件46和66可由相对刚性的橡胶、塑料、金属或其它类似材料构成。在图6的实施方式中，构成主体元件52的材料可以是柔性软塑料如硅，而主体元件54可由相对刚性的橡胶、塑料、金属或其它类似材料构成；或者相反。
变化形式
应理解，上述内容可发生变化而不背离本发明的范围，一些变化形式的例子如下所述。
每一个上述实施方式都可结合入能够促进骨质生长的任意常规物质，例如HA涂层、BMP等。
形成凹口42a、44a、52a、54a、62a和64a的主体元件42、44、52、54、62和64的表面可经过处理，例如具有齿件、脊、滚花等，以更好地夹持棘突。
主体元件42、44、52、54、62和64可由永久可变形的材料制成，从而提供抵靠棘突22的夹钳作用。
上述装置相对刚性的元件中可形成有通孔，以改善骨生长的融合性。
一个或多个上述实施方式的主体元件、插入件以及连接件可在形状、尺寸、组成和物理性质上变化。
各个上述实施方式中的一个或多个元件都可具有通孔，以接纳用于将装置附连于椎骨或棘突的系绳。
每个实施方式的相对刚性构件上可具有双侧突出件，以将装置系于椎骨或棘突。
上述相对刚性构件可由重吸收性材料制成，其刚性随时间变化。
在上述实施方式中，可提供用于连接各种主体元件的不同机构。
上述相对刚性构件可在术前或术中可由不同刚性的元件代替。
在每个上述实施方式中，由相对柔性柔软材料制成的元件可由相对刚性材料构成，由相对刚性材料制成的元件可以由相对柔性柔软材料构成。
上述实施方式的假体装置可植入除椎骨外的身体部分之间。
在切除了相邻椎骨间盘的椎间盘切除术之后，或者切除了至少一个椎骨的椎骨切除术之后，上述实施方式的假体装置可插入两个椎骨之间。
上述实施方式的假体装置可插入相邻椎骨的关节面之间，而不是棘突之间；并且
上文所述的空间标示，例如“下方”、“上方”、“之间”、“下侧”、“顶部”、“底部”等仅仅是为了示例的目的，而不是限制上文所示结构的具体取向或定位。
上述具体实施方式阐明了本发明的实施方式。因此，应理解，可采用本领域或本文所述领域技术人员已知的其它权宜方式而不背离本发明或所附权利要求书的范围，如上所述。在权利要求书中，装置加功能语句旨在覆盖执行所述功能时的本文所述结构，不仅结构等价形式而且等价结构。因此，虽然钉和螺钉不是结构等价形式，因为钉子采用圆柱面来使木制部件固定在一起而螺钉采用螺旋面，在紧固木制部件的情况下，钉子和螺钉是等价结构。

Claims (24)

1.一种用于插入相邻椎骨间的假体装置，所述装置包括：
第一构件；
第二构件；和
用于连接所述构件的机构；
所述构件之一由相对柔性材料形成，另一所述构件则由相对刚性材料形成。
2.如权利要求1所述的装置，其特征在于，所述机构包括在所述构件之一上形成的连接元件；另一所述构件中形成用于接纳所述连接元件的开口。
3.如权利要求1所述的装置，其特征在于，每个所述构件中形成有用于接纳椎骨之一的一部分的凹口。
4.如权利要求2所述的装置，其特征在于，所述椎骨部分是棘突。
5.如权利要求1所述的装置，其特征在于，所述相对刚性构件可以被刚性与另一所述构件不同的相对刚性构件所代替。
6.一种用于插入相邻椎骨间的假体装置，所述装置包括：
第一构件；
第二构件；和
用于连接所述第一和第二构件的机构；
所述构件中至少一个是相对刚性材料，至少一个其它构件是相对柔性材料。
7.如权利要求6所述的装置，其特征在于，所述第一和第二构件是相对柔性材料，所述机构的至少一部分是相对刚性材料。
8.如权利要求6所述的装置，其特征在于，所述机构包括分别在所述第一和第二构件上形成的连接元件以及具有用于接纳所述元件的开口的连接件。
9.如权利要求6所述的装置，其特征在于，所述机构包括在所述构件之一上形成的连接元件，所述连接元件适合延伸入另一所述构件中形成的对应开口中。
10.如权利要求6所述的装置，其特征在于，所述机构包括具有两个伸出元件的连接件，所述伸出元件可延伸入所述构件的对应开口中。
11.如权利要求6所述的装置，其特征在于，所述第一构件中形成用于接纳椎骨之一的一部分的凹口，所述第二构件中形成用于接纳另一椎骨的一部分的凹口。
12.如权利要求11所述的装置，其特征在于，所述椎骨部分是棘突。
13.如权利要求6所述的装置，其特征在于，所述相对刚性构件可以被刚性与另一所述构件不同的相对刚性构件代替。
14.一种将假体装置植入相邻椎骨之间的方法，所述方法包括：
在一个构件上形成一元件；
在另一构件中形成用于接纳所述元件而连接所述构件的开口；
形成相对柔性材料的所述构件之一；以及
形成相对刚性材料的所述另一构件。
15.如权利要求14所述的方法，其特征在于，所述方法还包括在至少一个构件中形成用于接纳椎骨一部分的凹口。
16.如权利要求15所述的方法，其特征在于，所述椎骨部分是棘突。
17.如权利要求14所述的方法，其特征在于，所述方法还包括用刚性与所述第一相对刚性构件不同的相对刚性构件代替所述相对刚性构件。
18.一种将假体装置植入相邻椎骨之间的方法，所述方法包括：
用第三构件连接第一构件和第二构件；
形成至少一个相对刚性材料的构件；以及
形成至少一个相对柔性材料的构件。
19.如权利要求18所述的方法，其特征在于，所述第一和第二构件是相对柔性材料，所述第三构件是相对刚性材料。
20.如权利要求18所述的方法，其特征在于，所述方法还包括在所述第一和第二构件上形成一元件，以及在所述第三构件中提供用于接纳所述元件的开口。
21.如权利要求18所述的方法，其特征在于，所述方法还包括分别在所述第一和第二构件中形成开口，以及在所述第三构件上提供两个可延伸入所述开口的元件。
22.如权利要求19所述的方法，其特征在于，所述方法还包括在所述第一构件中形成用于接纳椎骨之一的一部分的凹口，以及在所述第二构件中形成用于接纳另一椎骨的一部分的凹口。
23.如权利要求22所述的方法，其特征在于，所述椎骨部分是棘突。
24.如权利要求18所述的方法，其特征在于，所述方法还包括用刚性与所述第一相对刚性构件不同的相对刚性构件代替所述相对刚性构件。
CNA2006800278059A 2005-06-27 2006-06-20 脊柱稳定的椎间假体装置及其植入方法 Pending CN101232851A (zh)

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