CN1134810A - 改进的体内脊骨融合植入件 - Google Patents

改进的体内脊骨融合植入件 Download PDF

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Publication number
CN1134810A
CN1134810A CN96102702A CN96102702A CN1134810A CN 1134810 A CN1134810 A CN 1134810A CN 96102702 A CN96102702 A CN 96102702A CN 96102702 A CN96102702 A CN 96102702A CN 1134810 A CN1134810 A CN 1134810A
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China
Prior art keywords
spinal fusion
fusion implant
implantation piece
implantation
disc space
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Pending
Application number
CN96102702A
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English (en)
Inventor
加里卡林
米切尔森
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Medtronic Sofamor Danek Inc
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Medtronic Sofamor Danek Inc
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Publication of CN1134810A publication Critical patent/CN1134810A/zh
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    • A61F—FILTERS 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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    • A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A61F2310/00293—Ceramics or ceramic-like structures containing a phosphorus-containing compound, e.g. apatite
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Abstract

本发明揭示了一种用适合人体移植的材料制成的至少是部分圆筒形的脊骨融合植入件，它较理想但不是必要地具有一封闭端和一可被封闭端，以将任何的天然或人造的骨传导的、骨感应的、骨成长的或别的融合增强材料充填和保持在一内腔中。筒形的植入件直接参与，接着与融合结合在一起。在一较佳实施例中，本发明的植入件依靠其外表面上的表面粗糙结构以加强其稳定性并阻止其在两相邻脊椎骨之间的圆盘空间内的移位。本发明的植入件在其后端结合有一个有助于该植入件插入或抽出的啮合结构。该植入件可用促进融合的物质充填、敷涂、和/或上述的组合。最后，本发明的植入件不需要在插入时进行转动并且可以通过直线前进运动而就位。

Description

改进的体内脊骨融合植入件
本申请是1992.11.29提交的第07/968240号的共同待批申请的一个部分继续申请；第07/968240号申请又是1991.5.10提交的第07/698,674号申请的一个继续申请；而第07/698,674号申请是1988.6.3提交的第07/205,935号申请的一个分案申请，该第07/205,935号申请于已1991.5.14被批准为美国专利第5,015,246号。本申请还是1994.6.3提交的第29/023,926号及1994.6.3提交的第29/023,923号的共同待批的外观设计专利一个部分继续申请。
本发明涉及穿过在移去已损坏的脊骨圆盘后，横向放置在所留的脊椎骨之间的空间的人工脊骨融合植入件，尤其在两个具有必要高度的螺纹圆筒形植入件不能配装在脊椎骨横向宽度内的场合下，所涉及到的用于移植的一种经改进的，至少部分是圆筒状的脊骨融合植入件。
在过去，Cloward，Wilterberger，Crock，Viche，Bagby，Branti-gan，Michelson及别人已提示包括穿过两个相邻脊椎骨之间的圆盘空间进行钻孔以便产生体内脊骨融合的各种方法。Cloward提出了将一种骨钉放入那种钻出的孔内以便克服跨接的缺陷并被结合进入融合的方法。Viche提出了那种骨钉攻丝(车螺纹)的方法。Bagby提出了一种将骨植入件置放进一种金属筒内的方法，在该金属筒表面上除了与筒内部和骨植入件连通的多排径向设置的孔外，其余都是光滑的。Bagby的装置被揭示为可以应用于马。Brantgan提示了各种惰性块的使用，这些惰性块最好用金属制成并使金属外表面仿制有骨的气孔结构。Brantigan推论骨钉可完全用一种金属栓替代，这种金属栓虽然本身不主动融合，然而可用于从圆盘空间内部支撑脊椎骨而使融合围绕金属栓发生。
1974.11.19批准给Ma等人的美国专利第3,844,601号揭示了用于制备横越圆盘空间进入相邻脊椎骨的矩形空间和制备嵌插进该矩形空间内的骨头本身的矩形植入件的一种方法和器械。
于1988.5.10批准给Brantigan的美国专利第4,743,256号揭示了用以代替Ma等人提出的矩形骨植入件的一种矩形的惰性人造隔套。
在1989.11.7批准给Brantigan的美国专利第4,878,915号提示了用于体内脊骨融合的数种完全圆筒形的惰性植入件的使用。这类植入件并不参与骨头融合过程但起惰性隔套作用以便用于使骨头生长到该植入件的外表面上。
在1989.5.30批准给Brantigan的美国专利第4,834,757号揭示了一种代替矩形的骨头植入件或Brantigan的早期人工惰性隔套的矩形的空心脊骨融合植入件。
在1991.5.14批准给Michelson的美国专利第5,015,247号揭示一种薄壁多孔的螺纹空心圆筒形植入件，这种植入件的两端是封闭的或可封闭的以便压缩长满骨头或填满别的促进融合的材料。此外，所述Michelson装置可涂上一种如羟磷灰石(hydroxyapatite)那样的诱发骨头成长的化学药物。Michelson的专利还揭示了横越圆盘形空间并进入两相邻脊椎骨之间钻孔及安全地安装圆筒形植入件以使整个外科手术可通过一空心圆筒形管实施的方法。该空心圆筒形管在整个外科手术过程中可被留在适当位置上并可用来将相邻的脊椎骨保持在彼此相对的适当位置上以允许监视横越该圆盘形空间所进行钻孔并通过同一管子将该植入件插入横越圆盘形空间钻孔内和相邻的脊椎骨中。
就使用基本圆筒形的螺纹植入件进行体内脊骨融合的这种方法而言，当试图将两个圆筒形植入件(由于这是一个更加稳定的结构并具有比中央放置的单个植入件更大的表面积，因此可看作是较佳的数量)并排地横越一圆盘空间并置入两个相邻的脊椎骨内时，一个特殊问题便产生了：在那里，该圆盘空间具有这样的高度，即它要求一个植入件的直径大到足以穿入和可显然地衔接各相邻脊椎骨而不再可能并排置放两个这样的植入件和仍然使它们能容纳在脊椎的横向宽度内(见图1)。如果想要用并排置放的较小直径植入件以使两个植入件都能配装在脊椎的横向宽度内来解决该问题，则该植入件的高度就将不足以充分地衔接骨头。如果试图通过放弃这种并排的双植入件结构以利于单个的中央置放的植入件，为了有助于牢固的稳定则该植入件须大到足以占据圆盘空间横向宽度的一个足够部分，其垂直高度和进入脊椎骨的偏移是非常严重的，即如果对任何两个连贯的圆盘空间施行手术的话，则在中间的脊椎骨将要有一半需加切除。
于1991.10.8批准给Ray的美国专利第5,055,104号(“Ray专利”)揭示了一种植入件，这种植入件包括一无壁构件的螺旋线圈，在线圈置放在脊椎骨之间的圆盘空间内之后将植入件加以装配，按推想在脊椎骨已融合成一体之后就可取下线圈。Ray植入件是有缺点并难以操作的，这是由于它不能以这样一种方式被使用，按这种方式这种植入件被描述为它不能将一孤立的螺线圈插进硬骨头内，而没有任何支撑这样一个线圈的壁构件，这在结构上可能类似于早产的婴儿(见Ray专利，图1和7)。另外，Ray植入件过分复杂，这是由于它将不可避免地需要在圆盘空间内进行困难的装配工作。Ray专利文献的图3显示Ray并未提示过被截顶的圆筒形植入件的使用，而仅仅提示一种截顶的螺旋线圈的使用，这种线圈的外观象整个没有任何壁件的可被认为是圆筒形的一个磨尖的弹簧。因此，Ray仅仅揭示一种孤立的螺旋线的使用，它只能通过旋转被插进而不能直线地前进。
如果不可能插进一个孤立的无壁构件的螺旋线的种种不可抵抗的障碍和在圆盘空间内装配的问题可加以克服的话，然而Ray植入件由于它处在自发分解和机械故障的非常危险的状况，因此对于它要求达到的使用效果来说仍将是不安全的。另外，安全旋转这种装置以便插进的空间是不足够的，因为它只能满足使用一种具有减小横向宽度的装置。
因此就需要有一种这样的脊骨融合植入件，它可以插进在横越两块相邻脊椎骨之间的圆盘空间的一个钻孔中并部分地插入该两块相邻脊椎骨中，以使该脊骨融合植入件在与其相邻的第二同类插入件并排置放时可以装配在脊椎的横向宽度内。
本发明是一种经改进的体骨脊骨融合植入件，它可以插入在横越两块相邻脊椎骨之间的圆盘空间的一个钻孔中，并可插入该两块相邻的脊椎骨中以使该脊骨融合植入件在与其相邻的第二同类插入件并排置放时可以装配在脊椎的横向宽度内。本发明的脊骨融合植入件包括一个薄壁、多孔的圆筒或局部的圆筒，所述圆筒是用适合人体移植的材料制成并较理想，但并不是必要地，具有一封闭端和可以被封闭的一端，就如一个可以被充填和保持任何天然或人造的骨传导、骨感应、骨成长或别的融合增强材料的内室。本发明的脊骨融合植入件依靠其外表面的粗糙度以提高其稳定性。根据该脊骨融合植入件插进脊椎的横向宽度的尺寸大小，本发明的脊骨融合植入件可以有一个或一个以上的平侧面以减小脊骨融合植入件的宽度。本发明的脊骨融合植入件在其后端包括有一有助于较理想是在其后端插入或取出该植入件的衔接装置。本发明的植入件可以用融合促进物质制成、填充剂和/或敷涂剂。另外，本发明的脊骨融合植入件并不需要为其插入而加以旋转并可通过直线前进而就位。
本发明的脊骨融合植入件总的说来是有效而更安全的，并且用于当需要将两个并排的植入件插入已预备的圆筒形通道以及在两块相邻的脊椎骨之间的圆盘空间的高度相对于脊椎横向宽度如此之大以致两个具有必要高度的植入件不能配装在该脊椎的横向宽度内的特殊场合下要比已有技术的圆筒形植入件更为有效。已有技术已向知晓脊骨外科手术技术人员揭示了获得脊骨融合的可能性是与三个因素成比例的：(1)植入件的表面积(2)移植材料的质量和数量和(3)融合结构的稳定性。本发明的脊骨融合植入件通过使用两个并排横越一圆盘空间成为可能(否则该圆盘空间就会没有接受一个以上的足够宽度)就可提高这三个因素中的每一个。
由于下述原因，以其单个为基础而言，本发明的脊骨融合植入件要以已有技术更为灵验：
1.增大的表面积
本发明的脊骨融合植入件由于其表面粗糙度而有比具有光滑外表面的植入件更大的用于结合相邻脊椎骨的表面积。尽管满装有材料的孔可有效地提供表面上的接触面积，这些孔的存在与否实质上并不影响实际的表面积大小。本发明的局部圆筒形的植入件的圆弧部分与相邻的脊椎骨相接触从而提供了比由一非圆筒形植入件的平面部分所可能得到的表面积更大的表面积。
2.存在的移植材料的数量和质量
由于本发明的脊骨融合植入件不是旋入的，它就不需构制得可抵抗伴随而来的扭矩。这样，本发明的植入件可以有较薄的壁因而对一个给定直径而言具有较大的内部体积。本发明的脊骨融合植入件具有使它在受压时比没有上、下弯曲的支撑表面的植入件强度大的圆弧部分以使本发明的植入件可比这些植入件相对薄些。一种较薄的壁对骨头生长较为容易。另外，(interpore bridges)孔间跨接部可较小以允许较大的孔隙度从而有较大的对内部移植材料的暴露部分。此外，本发明的脊骨融合植入件可用已知的主动参与骨头融合过程可由不同的材料和/或化学基质构成的和/或用敷涂和/或用装填方法。由于本发明的脊骨融合植入件提供了较大的表面积和对于其外径而言的较大的内部体积，它就提供了使这些融合材料呈现较大表面积和体积的机会。
3.本发明的植入件提供了比已有技术的植入件更大的稳定性
具有最小稳定性的植入件是那些表面不粗糙的植入件。表面的孔由于增大植入件对相对表面的干涉因而提高了植入件的稳定性。本发明的脊骨融合植入件超过已有技术的进一步改进是在于本发明的脊骨融合植入件的表面粗糙度可阻止在各个方向上的运动。另外，所有植入件由于折回它所据以插进的通路而遭遇到退出的可能性。然后，本发明的脊骨融合植入件可具有将脊骨融合植入件向前推动的表面构形以提供抵止这种不需要的向后移动的更大阻力。此外，本发明的植入件的圆弧部分提供一较大的支撑面积以更好地分布通过脊椎骨的压力。
本发明的脊骨融合植入件由于它使用占有较小的空间，不需要预开孔(pre-tapping)以及可无需将一个器械在损伤脊骨的闭合边界内加以旋转而将植入件予以插进，因而使用较容易。此外，本发明的脊骨融合植入件比没有上下弯曲的成相同圆的弧形支撑面的植入件更容易插入，并且由于制备一个圆形孔可在单个步骤中钻出而比制备一方孔容易，这些植入件可横越圆盘空间插进相邻脊椎骨内。
本发明的一个目的是提供这样一种改进的体内脊骨融合植入件，以致可以置放两个并排地横越一圆盘空间的这样的植入件并植入相互紧密靠近的两块相邻的脊椎骨中以及处于脊椎的横向宽度范围内，在另一方面，脊椎的横向宽度相对于所需要的植入件高度就不足以容纳两个已有技术的圆筒状螺纹植入件。
本发明的另一目的是提供一种插入容易而无需在植入前进行开孔(tapping)的脊骨融合植入件。
本发明的又一目的是提供一种较为安全的脊骨融合植入件而无需在细软的结构附近进行急速的穿孔引线(run sharp threads)。
本发明的再一目的是提供一种不是通过旋转前进而通过直线前进运动可较快地移植在相邻脊椎骨之间的脊骨融合植入件。
本发明的别的一个目的是提供一种用于移植至少有一平侧面的局部圆筒形植入件的方法。
本发明的上述这些和其它的目的通过考察附图和遵照附图的详细说明将可看得更为清楚。
图1是人的脊柱一部分的示意图，图中的脊柱包括多块带有不同的圆筒形螺纹植入件的脊椎骨，这些植入件是横越圆盘空间而插入两块相邻的脊椎骨之间，该图用于说明采用那些植入件所遇到的问题。
图2是沿图1的2-2线所取的、顶脊椎骨去掉后的具有两个圆筒形螺纹植入件的俯视图，图中示出彼此靠近的两螺纹植入件置放在横越圆盘空间时在它们之间的可能的最小距离。
图3是本发明的脊骨融合植入件的一实施例的立体侧视图，该实施例具有棘牙形式的表面粗糙结构。
图4是图3的脊骨融合植入件的一个第一侧视图。
图5是两个图3的脊骨融合植入件的俯视图，图中示出当将彼此靠近的两个植入件置放横越圆盘空间时，在它们之间的可能的最小距离。
图6是图3的脊骨融合植入件的一第二侧视图。
图7是沿图6的脊骨融合植入件的7-7线所取的剖视图。
图8是沿图6的脊骨融合植入件的8-8线所取的剖视图。
图9是图3的脊骨融合植入件的顶端视图。
图10是图3的脊骨融合植入件的底端视图。
图11是本发明的脊骨融合植入件的一替代实施例的立体侧视图。
图12是图11的脊骨融合植入件的一第一侧视图。
图13是图11的脊骨融合植入件的一第二侧视图。
图14是沿图13的脊骨融合植入件的14-14线所取的剖视图。
图15是本发明的脊骨融合植入件的一替代实施例的一立体侧视图，该实施例具有滚花形式的表面粗糙结构。
图16是图15的脊骨融合植入件的一第一侧视图。
图17是两个图15的脊骨融合植入件的俯视图，图中示出当将这两个植入件彼此靠近地横越圆盘空间置放时，它们之间的可能的最小距离。
图18是沿图16指示线18所视的一个放大的局部视图，图中示出图15的植入件的表面的结构形状。
图19是图15的脊骨融合植入件的一第二侧视图。
图20是沿图16的脊骨融合植入件的20-20线所取的剖视图。
图21是图15的脊骨融合植入件的一顶端视图。
图22是图15的脊骨融合植入件的一底端视图。
图23是本发明的脊骨融合植入件的一替代实施例的立体侧视图，该实施例具有两个平侧面和棘牙形式的表面粗糙结构。
图24是图23的脊骨融合植入件的一第一侧视图。
图25是人的脊柱一部分的示意图，图中示出被插置在该脊柱内的两个本发明的图23所示的植入件。
图26是沿图25的26-26线所取的将上面脊椎骨取走后俯视图，图中示出并排地横越圆盘空间置放的两个图23的脊骨融合植入件之间的可能的最小距离。
图27是图23的脊骨融合植入件的顶端视图。
图28是图23的脊骨融合植入件的一底端视图。
图29是图23的脊骨融合植入件的一第二侧视图。
图30是沿图29的脊骨融合植入件的30-30线所取的剖视图。
图30A是本发明的脊骨融合植入件的一替代实施例的剖视图，该实施例只有一个平侧面。
图31是本发明的脊骨融合植入件的一替代实施例的一立体侧视图，该实施例具有两个平侧面和棘牙形式的表面粗糙结构。
图32是图31的脊骨融合植入件的一第一侧视图。
图33是图31的脊骨融合植入件的一第二侧视图。
图34是沿图33的脊骨融合植入件34-34线所取的剖视图。
图35是沿图33的脊骨融合植入件35-35线所取的剖视图。
图36是本发明的脊骨融合植入件的一替代实施例的立体侧视图，该实施例具有两个平侧面和滚花形式的表面粗糙结构。
图37是图36的脊骨融合植入件的一第一侧视图。
图38是图36的脊骨融合植入件的一第二侧视图。
图39是沿图38的脊骨融合植入件的39-39线所取的剖视图。
图40是沿图37的线40所取的一个放大的局部视图，图中示出图36的脊骨融合植入件的表面结构形状。
图41是本发明的脊骨融合植入件的一替代实施例的立体侧视图，该实施例具有由冲击波形(blasted)外表面组成的表面粗糙度。
图42是本发明的脊骨融合植入件的一替代实施例的一立体侧视图，该实施例具有两平侧面和垂直及水平槽形式的开孔。
图43是脊柱一部分的侧视图，该脊柱部分带有本发明的两个脊骨融合植入件的一替代实施例，该实施例具有横越圆盘空间被插进的对应的凹侧面和凸侧面，以及还带有本发明的单个脊骨融合植入件的另一替代实施例，该实施例有横越一圆盘空间而插进的两个圆筒状部分。
请看图1，它示出总的用S字母表面的人体脊柱的一部分。该脊柱一部分S包括多块脊椎骨V和在两块相邻脊椎骨V之间的一个圆盘形空间D。图中示出各种各样的各具有不同直径的圆筒形螺纹脊骨融合植入件，它们横越过该圆盘空间D而被插入。
当该圆盘空间D的高度Hs大到可使两个圆筒形植入件，例如脊骨融合植入件10a和10b(其每一个具有横穿该圆筒空间D的足够大的直径并可充分地嵌入相邻脊椎骨V的骨头中，该两个脊骨植入件10a和10b被置放于横越该圆盘空间D处，它们的组合总宽度超过脊柱S的横向宽度Ws。其结果是，各植入件10a和10b的一部分伸出脊柱S的两侧并且由于位于脊柱S邻近的灵敏和维持生命结构会对病人产生严重和可能是致命的伤害，以致使用两个圆筒形的脊骨融合植入件10a和10b是不合乎需要的。
如果不是用两个脊骨融合植入件10a和10b，而是使用具有可提供稳定性和融合的足够大的直径的单个植入件，例如脊骨融合植入件12a，则该植入件会深深地穿入相邻的脊椎骨V。该脊骨融合植入件12a具有一明显大于其高度Hs的直径，因此，可基本上穿透脊椎骨V以容纳大直径的脊骨融合植入件12a。结果是，去掉脊椎骨V的大部分，因而该块脊椎骨V的整个结构的完整性实际上被削弱。尤其是当将一与脊骨融合植入件12a相同的第二脊骨融合植入件12b放置在横穿在该同一脊椎骨V的另一侧上的圆盘空间D上时就会出现使两块脊骨融合植入件12a和12b被放置在横越该脊椎骨V的任一侧上的圆盘空间D上的问题。其结果是，该块脊椎骨V被切开成一个如图1所示的“蝴蝶”形状，并且该块脊椎骨V的结构完整性和强度进一步降低以致实质上减低了脊骨融合过程的有效性以及使脊椎骨V遭受血行阻断(devascularization)和断裂的很大的危险性。
相反，如果是用如脊骨融合植入件14a和14b那样的两个圆筒形植入件，其每一个有足够大小的直径以使它们在被并排地置放在该圆盘空间D内时，它们的组合总宽度刚好填满脊柱S的横向宽度Ws，则每一脊骨融合植入件14a和14b的直径就不够大到可横穿过圆筒空间D而与脊椎骨V相衔接。因此，尽管脊骨融合植入件14a和14b并不伸出脊椎S的两侧，但脊骨融合植入件14a和14b不能到达和衔接脊椎骨V的骨头，因而不能起到稳定相邻的脊椎骨V的作用。
请看图2，它是沿图1的2-2线所取、去掉上脊椎骨V后具有两个放置在横越圆盘空间D内的圆筒形螺纹植入件10a和10b的一个俯视图。
螺纹植入件10a和10b具有一外螺纹11a和11b，它们必须有与该螺纹植入件的有效尺寸成正比的最小高度。螺纹植入件10a和10b的螺纹11a和11b将扭矩转变成直线运动，以致螺纹11a和11b需要有足够的高度以克服将螺纹植入件10a和10b插入例如骨头那样的材料阻力，这种阻力与各螺纹植入件10a和10b的表面积和直径成正比。这样，在各螺纹植入件10a和10b的外径(包括螺纹)与根径(减去螺纹)之差是这样的值，即当两个螺纹植入件10a和10b被植入在横越圆盘空间D的相邻脊椎骨V内时，必须有为螺纹11a和11b的高度允许的在两个螺纹植入件10a和10b之间的最小距离。这是正确的，即便螺纹11a和11b是犬牙交错的，螺纹植入件10a和10b仍然是偏置的，偏置值至少是螺纹植入件10a和10b之一至少为螺纹的高度。这样的在两个螺纹植入件10a和10b之间的一个最小距离增加了插入后的两螺纹植入件10a和10b的组合总宽度。
因此，为了使圆筒形脊骨融合植入件可应用于脊骨融合过程中，两相邻脊椎骨V之间的圆盘空间D的高度Hs相对于其宽度Ws是较大的，就必须要有这样一种植入件，该植入件可以比螺纹植入件所可能有的更紧密的接触，且被移植在其同类的第二植入件附近，而仍可提供这样一个植入件表面，该植入件表面在与相邻脊椎骨衔接时可以提供机械稳定性。由于通过钻一个横穿圆盘空间D并进入相邻脊椎骨V的圆筒形孔来制取容纳植入件的空间比较容易，因此使用一个圆筒形植入件是合乎要求的。钻进脊椎骨V的圆筒形孔的曲面具有比一平面增大的表面积，并且当该圆筒形孔与具有有配合直径的对应圆筒形部分的一个植入件配装时可提供紧配的可能性。
请看图3至10，图中示出本发明的脊骨融合件的一实施例，它总的用标号100表示。该脊骨融合植入件100具有一基本圆筒形的构形，它有一环绕一内腔114的外壁112和一纵向中心线L。该脊骨融合植入件100的外部由表面粗糙结构组成，该粗糙结构提供了一适合于与脊椎骨V衔接的表面以便一旦使用外科植入手术使脊骨融合植入件100穿过圆盘空间D进入相邻椎骨V后得以稳定。在脊骨融合植入件的一实施例100中，所述表面粗糙结构包括有沿着所述脊骨融合植入件周围的多个棘牙120。多个棘牙120的每一个具有一骨头衔接边缘122和一斜角部124。
多个棘牙120的每一个具有这样的高度，该高度基本小于同尺寸的一个圆筒形螺纹植入件所必需的螺纹高度。由于螺纹是用于将扭矩转变成直线前进运动的简单装置(结构)，因此螺纹的必要高度是与其植入件的表面积和直径成正比的并且其高度大到足以牵引圆筒形植入件，此圆筒形螺纹植入件具有可横过圆盘空间D的足够大的直径以便穿过一种如同骨头那样的紧密材料。相反，由于脊骨融合植入件100是通过直线前进运动穿过圆盘空间D植入相邻的脊椎骨V的，棘牙120的高度就要明显小于同尺寸的螺纹植入件的必要螺纹高度。该脊骨融合植入件100由于它不需要将其穿过脊椎向前牵引的螺纹因而可直接通过线性前进运动被推入圆筒形的圆盘空间D内。由于不需要使脊骨融合植入件100前进的扭矩，就不存在表面粗糙结构的必需的最小高度。这必需的表面特点仅仅在于它给于该脊骨融合植入件100一旦被移植后的稳定性。
另外，棘牙120面朝着将脊骨融合植入件100插入的方向，并起着这样的作用，即可在脊骨融合植入件100一旦被插入两相邻脊椎骨V之间棘牙120按与所述插入方向的相反方向阻止其退出圆盘空间D。棘牙120面对脊椎骨V的未被去掉的骨头将脊骨融合植入件100向前推动。由于一些植入件一般是要沿着它们被插入的相同路径退出，例如病人身体超过规定时间的重复运动而这可使一些别种设计的植入件变得松动(例如可能拧松一螺纹圆筒形植入件)，因此棘牙120趋向于脊骨融合植入件100面对坚固的未去掉的骨头向前推进以进一步阻止移位和控制运动从而产生非常稳定的移植。
棘牙120的骨头衔接边缘122具有从脊骨融合件100的齿根直径测得的在最高点上的高度，该高度约为0.35毫米。以这种方式，该脊骨融合植入件100可以约0.7毫米的间隔距离置放在其同类的第二个植入件旁边或者如果偏置则甚至可更靠近，从而在将这样两个脊骨融合植入件100进行外科手术植入时实质上可减小它们的组合总宽度。所述的棘牙120的高度可以在0.25至1.5毫米范围内，而较理想的高度是0.35至0.75毫米。
请看图5，如图所示两个脊骨融合植入件100a和100b横穿圆盘空间D被插入，该圆筒空间D具有与图2中所示的圆盘空间D的同样尺寸。当与如前述和在图2中示出的并排设置的两个螺纹脊骨融合植入件相比较时，这两个脊骨融合植入件100a和100b具有减小的组合总宽度。两个脊骨融合植入件100a和100b的被减小后的组合总宽度是它们的外径和齿根直径之差并且是通过利用用于稳定的如棘牙120那样的表面粗糙结构得到的。这些表面粗糙结构可使两个脊骨融合植入件100a和100b彼此相当靠近从而使插入它们所需要的总横向宽度要比具有同一齿根直径的两个螺纹圆筒形植入件的可能要小(由于这种螺纹植入件的必要的螺纹高度)。减小两植入件之间的偏置可允许使用较大直径的植入件，它们还可以配装在脊柱的横向宽度Ws内并达到与相邻脊椎骨V的更明显的衔接。
请看图7，图中示出该脊骨融合植入件100的一个横剖面，其中壁112具有穿过它而与内腔114连通的通孔128。该内腔114可充填骨头材料或任何天然或人造的骨头生长材料或促进融合的材料，以使骨头的生长发生在从脊椎骨V通过通孔128进入内腔114内的材料时。尽管图中已示出这些通孔128为圆形，但可意识到在本发明的范围内，所述通孔128还可以具有适用于脊骨融合植入件的任何形状、尺寸或形式。另外，通孔的数目可以是不同的，或在该脊骨融合植入件上不设有通孔。
请看图8和9，该脊骨融合植入件100具有带螺纹132的一个盖帽130，它可通过螺纹连接到脊骨融合植入件100的一端上。一旦该盖帽130装配到脊骨融合植入件100上，其边缘136在脊骨融合植入件100横越圆盘空间D被植入时起进一步稳定脊骨融合植入件的一个附加棘牙120的作用。
该盖帽130是可拆卸的以提供通向内腔114的通路，以使内腔114可用任何自然或人造的骨传导的、骨感应的、骨成长的或其它的融合加强材料加以充填和保持。这类材料的一些例子是取自病人的骨头、或骨头生长感生材料，例如但并不限于，羟磷灰石、羟基磷灰石三钙磷酸盐(hydroxyapatite tricalcium phosphate)；或骨头形态形成蛋白质(bone morphogenic protein)。该盖帽130和/或该脊骨融合植入件100本身是由适合于人体移植材料制成的，(如钛的材料)和或用一种骨头向内生长的感生材料，例如但并不限于，羟磷灰石或羟磷灰石三钙磷酸盐或任何别的骨传导的、骨感生的、骨成长的或别的融合加强材料制成和/或充填和/或敷涂的。
请看图4，盖帽130a还可以使用有助于插入的“锥体”形。该盖帽130a在其最大直径处的直径等于脊骨融合植入件100的齿根直径从而没有附加棘牙120的形成。
请看图10，该脊骨融合植入件100在其一端上具有一个矩形槽140形式的啮合结构，它用于与一带有可紧密啮合该矩形槽140的可拆卸啮合结构的一个驱动器相啮合。在一个实施例中，该驱动器的螺纹部分是作为一贯穿一空心管状件的杆件并可被转动操纵，用以旋入在该槽140中的螺孔142内并使该植入件100与驱动器紧固在一起。一旦该脊骨融合植入件100被固定于该植入件的驱动器上，它就可以通过一空心圆筒形管而被插入并被驱入横穿圆盘空间D中已被钻出的圆筒形孔内。然后可用一木槌或较小的装置撞击该植入件的驱动器以使该脊骨融合植入件100穿过该圆盘空间D或直线地推进。一旦该脊骨融合植入件100横穿圆盘空间D而被插入时，棘牙120就衔接脊椎骨V的骨头而使植入件驱动器与脊骨融合植入件100分离。用于横穿圆盘空间D的钻孔步骤和相配合使用的器械在共同待批的于1993.6.10提出的第08/074,781号申请中予以了说明，一并援引在此。
请看图11至14，图中示出本发明的脊骨融合植入件的一个替代实施例，它总的用标号200表示之。除了通孔228被多个棘牙220的骨头衔接边缘222对开(等分)外，该脊骨融合植入件200与脊骨融合植入件100相同。以这种方式，骨头衔接边缘由通孔228所中断以提供一“牙齿状”边缘，该“牙齿”边缘与脊椎骨V的骨头相衔接并产生一个过盈配合以防止该植入件200一旦被插入后的退出。应意识到在本发明的范围内，通孔228的数目和骨头衔接边222的数目可以是不同的并且通孔228可以相对于该棘牙220或别的表面粗糙结构的任何方位设置。
请看图15至19，图中示出本发明的脊骨融合植入件的一替代实施例，它总的用标号300表示。该脊骨融合植入件300具有一个带有将植入件300稳定在椎间的空间D内的表面粗糙结构的基本圆筒形的构形。如在图18中所示，该表面粗糙结构由表面滚花320，如图示的但并不局限于的菱形骨啮合图案组成。在本发明的范围内，脊骨融合植入件300可以遍布在脊骨融合植入件300的整个外表面上或仅遍布在该外表面的一部分上，且具有表面滚花320或具有它们的任何组合。在脊骨融合植入件300的前面的圆盘空间D内不存在任何阻碍植入件进一步向前推动的未加以钻孔的骨头的那些情况下，表面滚花320是较佳的，因为它可产生一个与脊椎骨V的骨头的很大过盈配合并在各个方向上都一样地阻止运动和没有推动它本身向前的趋势。
请看图17，两个穿圆盘空间D而被植入的脊骨融合植入件300a和300b可并排地设置，该圆盘空间D具有与在图2中所示的圆盘空间D同样的尺寸，以使两个脊骨融合植入件300a和300b彼此接触因而使两个脊骨植入件300a和300b的总结合宽度减小到一带有粗糙表面的基本圆筒形植入件所可能有的最小距离。以这种方式，具有可横越圆盘空间D的高度Hs的足够大的直径的两个圆筒形脊骨融合植入件300a和300b可以在不超出脊柱S的横向宽度Ws的情况下设置在穿过该圆盘空间D内。脊骨融合植入件300a和300b通过如上所述的用于脊骨融合植入件100的直线前进运动而被插入。因此，由于脊骨融合植入件300a和300b的插入不需要螺纹，与在用螺纹植入件时螺纹所需的占有空间相比较，在该两个脊骨融合植入件300a和300b之间只需要有较小的空间或不需要有空间。这样，脊骨融合植入件300a和300b可以靠近一起放置以基本上减小这样的两个植入件的总组合宽度。
请看图23-30，图中示出本发明的脊骨融合植入件的一替换实施例，它总的用标号400表示。除了它包括一局部(不完全的)圆筒形件外，该局部圆筒形件有与其外壁405的部分相同的圆弧的弧形部分402和404，而所述外壁405的一部分是平的以形成第一平侧面406和第二平侧面408这一点之外，该脊骨融合植入件400具有一个与脊骨融合植入件200相同的构形。
请看图28，该脊骨融合植入件400具有一外径M，该外径等于两个正好相反的未削平部分，例如具有相同圆弧的弧形部分402和404之间的距离。该脊骨融合植入件400的宽度Wi等于在一削平部和正好与该削平部相对的一点例如在每一平侧面406和第二平侧面408之间的距离。
请看图25，图中示出含有多块脊椎骨V的一脊柱S的一部分，其中具有两个横穿圆盘空间D而被插进两相邻脊椎骨V之间的脊骨融合植入件400a和400b。脊骨融合植入件400a和400b是相同的并且每一个分别有第一圆弧部402a和402b；分别有第二圆弧部404a和404b；分别有第一平侧面406a和406b；以及分别有第二平侧面408a和408b。脊骨融合植入件400a和400b利用脊骨融合植入件400a的第二平侧面408a面对和靠近脊骨融合植入件400b的第一平侧面408b而使它们横穿圆盘空间D而被植入，从而使两个脊骨融合植入件400a和400b的组合总宽度小于植入件的最大直径M的两倍。脊骨融合植入件400a和400b通过如上所述的用于脊骨融合植入件100的线性前进运动而被插入。
在移植前，钻出两个穿圆盘空间D的并进入相邻的脊椎骨V内的局部重叠的圆筒形孔。这两个孔被钻得足够重叠以使两个脊骨融合植入件400a和400b通过与圆盘空间D的平面相垂直的两平侧面被植入，而该圆盘空间D是处在与如图25所示的脊柱S的纵向垂直轴线A相垂直的一个平面上。
该脊骨融合植入件400a和400b可以这样分开地被插入以致一旦第一脊骨融合植入件400a横穿圆盘空间D而被插入时，第二脊骨融合植入件400b就被驱动以横穿该圆盘空间D，从而使各脊骨融合植入件400的平侧面402或404彼此相邻并接触。以这种方式，两个脊骨融合植入件400a和400b被横向植入该圆盘空间D内并衔接相邻脊椎骨V的骨头而不会超出脊柱S的横向宽度Ws。或者，两个脊骨融合植入件400a和400b可通过在植入前在按如上所述的方位将它们彼此相邻地和面对面地放置而同时地横向植入该圆盘空间D。然后两个脊骨融合植入件400a和400b被直线地向前推入横穿该圆盘空间D的钻孔中。
请看图28，具有第一和第二平侧面406和408的成果在于脊骨融合植入件400的总宽度Wi基本上被减小，而脊骨融合植入件400的高度却保持脊骨融合植入件400的圆筒形部分的最大直径M。
请看图25和26，由于各脊骨融合植入件400a和400b的高度足够横穿圆盘空间D并进入两相邻脊椎骨V中，各脊骨融合植入件400a和400b与相邻的脊椎骨V的骨头衔接，然而，两个脊骨融合植入件100的组合宽度并不超出脊柱S的横向宽度Ws。因此，就可以获得这样的优点，即可将两个圆筒形植入件并排地置放在横穿圆盘的空间D而不超出脊柱S的宽度Ws。这样，如图26所示，该两个脊骨融合植入件400a和400b可穿过圆盘的空间D而被插入，该圆盘空间D具有与图2所示的圆盘空间D相同的尺寸，并且由于第一平侧面408b被置放于第二平侧面408a近旁，因此可置放得非常靠拢，而且可继续衔接相邻的脊椎骨V。
如图30所示，该脊骨融合植入件400具有一个空心的中央内腔41 4和一系列穿过外壁405并进入所述脊骨融合植入件400的中央腔404的通孔428。在第一和第二平侧面406和408上也可以有通孔428。尽管所述通孔428(例如如图所示)是圆孔，但是可以是任何别的只要符合其使用目的可加工的构形，这些形状可包括(但并不是限于)适用于上述圆筒形植入件任一种的非圆形的椭圆、切口、槽和孔。
请看图30A，应认识到脊骨融合植入件400’可以只有一个平侧面，从而只提供一个平侧面406’，这也是在本发明的范围内。这个构形在脊骨融合植入件400的宽度Wi仅需相对于其最大直径M而言是稍微减小的，从而可防止这两个植入件的组合总宽度不超过脊柱S的横向宽度Ws的场合下是合适的。
请看图23、24和29，本发明的脊骨融合植入件400具有如上述对脊骨融合植入件100的说明那样的沿着脊骨融合植入件400周边的圆筒形部的外表面且面对一个方向的多个棘牙420。这些棘牙420具有骨头衔接边422，而棘牙420的成角度的构形由于该衔接边422与脊椎骨V的接合(衔接)可防止脊骨融合植入件400在相反方向的运动而提供了一种脊骨融合植入件400的“单向”插入。然而，所述的平侧面第406和408最好是光滑的并有一个可使两个脊骨融合植入件400a和400b尽可能靠近置放的平表面。各个棘牙420的骨头衔接边422叉开等分这些孔以增加移植后的脊骨融合植入件400的稳定性。
脊骨融合植入件100至600，其每一种都有一个20毫米至30毫米范围内，最好是25毫米的总长度和一个14毫米至24毫米范围内的最大直径M，当从后面进路将脊骨融合植入件插入脊椎骨时最好为18毫米及当从前面进路将其插入腰脊骨时最好为20毫米的最大直径M。这种脊骨融合植入件400也十分适合于用在颈脊骨和胸椎骨上。用于颈椎骨上的这类植入件长度可以是10至18毫米范围内最好是12毫米，其最大直径M在12至20毫米范围内最好是16毫米。用于胸椎骨上的这类植入件的长度可在16至26毫米范围内其最大直径是在14至20毫米范围内，而最好是16毫米。除了前述尺寸外，用于颈椎骨的脊骨融合植入件400至600的宽度Wi是在8至16毫米范围内最好是10至14毫米；用于腰椎骨的脊骨融合植入件的宽度Wi在18至20毫米范围内，宽度Ws最好为18至20毫米；以及用于腰椎骨的脊骨融合植入件的宽度Wi在18至26毫米范围，最好是20至24毫米。
请看图27和28，当端视时，本发明的脊骨融合植入件400具有圆形的外部几何形状，但其两侧部分被垂直地正切割掉以形成第一和第二平侧面406和408。盖帽430沿着在脊骨融合植入件400一端上的第一第二圆弧部分402和404伸出壁412的最狭直径而起着一衔接缘436的附加棘牙420的作用。以这种方式，该附加棘牙420还起着当脊骨融合植入件400被插入在相邻脊椎骨V之间时可提高其稳定性并进一步阻止脊骨融合植入件400移离圆盘空间D的作用。盖帽430与平侧面406和408齐平以维持平侧面406和408的扁平表面。该盖帽430还有与平侧面406和408位置对应的有利于插入脊骨融合植入件400的两个倾斜侧面438a和438b因而允许两个脊骨融合植入件400并排靠拢设置。或者，盖帽430始终在其周围与脊骨融合植入件400的齿根直径平齐以便更方便地插入一较长的斜面长度。
该脊骨融合植入件400具有例如(但并不限于)棘牙420那样的表面粗糙结构，因此脊骨融合植入件400的外表面具有多种其它表面粗糙结构，这样就可增强脊骨融合植入件400的稳定性并在横穿圆盘空间D植入时阻止植入件的移位。例如，脊骨融合植入件可以具有可通过喷丸或粗铸等方法形成的不规则外表面。这样一种不规则表面可以被单独使用或结合别的表面粗糙结构，例如棘牙和或滚花并且如前已讨论过的，通孔428可以是孔、槽、切口或其它形状。
请看图32至35，图中示出本发明的脊骨融合植入件的一个替代实施例，它总的用标号500表示。除了通孔528是设置在棘牙520上以使通孔528位于两骨头衔接边522之间而不是由骨头啮合边缘522所叉开等分外，脊骨融合植入件500基本上与脊骨融合植入件400相同。用这种方式，骨头衔接边522是连续和不间断地衔接脊椎骨V的骨头并防止植入件500一旦插入后的退出。
请看图36至40，图中示出本发明的脊骨融合植入件的又一替代实施例，它总的以标号600表示。它不使用棘牙420，而使用具有例如(但并不限于)如图40所示的菱形骨头衔接图案的表面滚花620，该脊骨融合植入件600基本上与上述的脊骨融合植入件400相同。表面滚花620在脊骨融合植入件600一旦横穿圆盘空间D而被插入在两相邻脊椎骨V之间时，有助于固定植入件。应认识到植入件600的表面滚花620可以与任何数量的其它的例如(但并不限于)棘牙那样的表面粗糙结构相组合，这样有助于保持横穿圆盘空间D的脊骨融合植入件600。
如图36所示，脊骨融合植入件600的盖帽630具有对应于第一第二平侧面606和608的倾斜侧面660和662，这样有助于插入脊骨融合植入件660并可允许两个脊骨融合植入件600并排靠近置放。
应看到植入件发明可以包括任何和所有的或可增加植入件与脊椎骨V的配合表面积或者是过盈配合的表面粗糙结构的形状。还应看到用于本发明的脊骨融合植入件的各个不同实施例的上述棘牙结构还可以包括与这些棘牙组合的滚花或别的表面粗糙结构以进一步加强对插入后横穿过该圆盘空间D的脊骨融合植入件的保持力。
请看图41，图中示出本发明的脊骨融合植入件的又一个替换实施例，它总的用标号700表示。脊骨融合植入件700具有由经喷丸过的外表面701组成的表面粗糙结构以便在植入件横穿圆盘空间而被插入时提供脊椎骨V衔接表面。该脊骨融合植入件具有多个通孔728，一个可拆卸盖帽730，可拆卸盖帽730具有与六角形工具啮合的六角槽734。
请看图42，图中示出本发明的脊骨融合植入件的一替代实施例，它总的用标号800表示。该脊骨融合植入件800除了它具有在其平侧面806上的水平切口828和其圆筒形部分上的垂直切口829形式的通孔外，是与上述的脊骨融合植入件400相同的。
应看到，在本发明的范围内，本发明的脊骨植入件可以具有任何可使两个这种脊骨融合植入件的组合总宽度小于它们的最大直径M两倍的构形。
请看图43，图中示出带有两个横穿圆盘空间D，而被插入的脊骨融合植入件900a和900b的一个替代实施例的脊柱S的一部分。脊骨融合植入件900a有一个凹表面902，该凹表面具有对应的容纳脊骨融合植入件900b的凸表面的形状。当两个脊骨融合植入件900a和900b被并排置放时，该凹表面902与凸表面904配合使两个脊骨融合植入件的组合总宽度小于两倍的它们的最大直径。因此，两个局部圆筒形的植入件相对于脊椎骨V的衔接部而并排地横穿圆盘空间D被插入的优点，在于不超出脊柱S的宽度Ws的情况下获得。
请再看图43，图中示出本发明的脊骨融合植入件的又一个替换的实施例，它由横穿脊柱S的圆盘空间D2的单个脊骨融合植入件1000组成。该脊骨融合植入件1000由一第一圆柱形部1010和一第二圆柱形部1012组成并可以具有任何的参照上述实施例所说明的表面粗糙结构。在该较佳实施例中，该脊骨融合植入件1000是通过直线推进到穿过圆盘空间D2钻出的重叠的圆筒形孔内而被插入的。
尽管本发明是就其一些较佳实施例予以了说明的，但应理解到，在不违背发明构思的情况下和在本发明的范围内还可以对本发明设计出其它种种的技术方案。

Claims (32)

1.一种用适合于人体移植的材料制成的部分圆筒形的脊骨融合植入件，它包括一个具有一条纵向中心轴线和至少与所述中心轴线平行的一第一平侧面的圆筒体。
2.如权利要求1所述的脊骨融合植入件，其特征在于，所述植入件具有多个平侧面。
3.如权利要求1所述的脊骨融合植入件，其特征在于，所述植入件具有在直径方向上与所述第一平侧面相对的一第二平侧面。
4.如权利要求1所述的脊骨融合植入件，其特征在于，所述植入件具有一个内腔。
5.如权利要求4所述的脊骨融合植入件，其特征在于，所述内腔可以容纳促进融合的材料。
6.如权利要求4所述的脊骨融合植入件，其特征在于，所述植入件包括有环绕所述内腔的一个壁。
7.如权利要求6所述的脊骨融合植入件，其特征在于，所述的壁具有多个穿过壁与所述内室连通的通孔。
8.如权利要求1所述的脊骨融合植入件，其特征在于，它有多个可以保持促进融合材料的通孔。
9.如权利要求1所述的脊骨融合植入件，其特征在于，所述植入件具有一个大于在两块相邻脊椎骨之间的圆盘空间的外径。
10.如权利要求1所述的脊骨融合植入件，其特征在于，它还包括用于衔接所述的两相邻脊椎骨并使所述植入件保持在适当位置的多个表面粗糙结构，所述表面粗糙结构存在于所述植入件外部的至少一部分上。
11.如权利要求10所述的脊骨融合植入件，其特征在于，所述的表面粗糙结构包括多个棘牙。
12.如权利要求1所述的脊骨融合植入件，其特征在于，所述的棘牙是面向一个方向。
13.如权利要求10所述的脊骨融合植入件，其特征在于，所述的表面粗糙结构包括滚花。
14.如权利要求1所述的脊骨融合植入件，其特征在于，所述的植入件包括一种内长骨头的材料。
15.如权利要求4所述的脊骨融合植入件，其特征在于，所述植入件具有至少一个用于封闭至少所述内腔的一端的可拆卸盖帽。
16.如权利要求1所述的脊骨融合植入件，其特征在于，所述植入件的一端包括一用于插入植入件的器械啮合的一个啮合结构。
17.如权利要求1所述的脊骨融合植入件，其特征在于，所述的圆筒体包括作为同一个圆的两个圆弧的在直径方向相对端上的第一和第二圆弧部分。
18.一种用适合于人体移植的材料制成的中空局部圆筒形脊骨融合植入件，它包括：
具有一纵向中心轴线和至少一个平行于所述中心轴线的第一平侧面的一个圆筒体，其特征在于，所述植入件具有大于在两块相邻脊椎骨之间的圆盘空间的高度的一个外径和从所述第一平侧面到所述圆筒体的一个直径端上相对部所测得的一个宽度，所述宽度小于所述的外径。
19.一种用适合于人体移植的材料制成的中空圆筒形的脊骨融合植入件，它包括：
具有一个环绕一内腔的壁的圆筒形构件，所述壁有穿过它与所述内腔连通的的多个通孔，所述植入件具有多个在该圆筒形构件外表面上的表面粗糙结构，它们用于衔接所述脊椎骨以将所述植入件保持在适当位置上。
20.如权利要求19所述的脊骨融合植入件，其特征在于，所述的表面粗糙结构包括多个棘牙。
21.如权利要求20所述的脊骨融合植入件，其特征在于，所述棘牙都面向一个方向。
22.如权利要求19所述的脊骨融合植入件，其特征在于，所述的表面粗糙结构包括滚花。
23.如权利要求19所述的脊骨融合植入件，其特征在于，所述的植入件包括一种内长骨头的材料。
24.如权利要求19所述的脊骨融合植入件，其特征在于，所述的内腔可以保持促进融合的材料。
25.如权利要求19所述的脊骨融合植入件，其特征在于，所述多个通孔可以保持促进融合的材料。
26.如权利要求19所述的脊骨融合植入件，其特征在于，所述植入件具有大于在两相邻的被融合的脊椎骨之间的圆盘空间的一个外径。
27.如权利要求19所述的脊骨融合植入件，其特征在于，所述植入件有用于封闭所述内腔的至少一端的至少一个可拆卸的盖帽。
28.如权利要求19所述的脊骨融合植入件，其特征在于，所述植入件包括一种促进融合的材料。
29.如权利要求1所述的脊骨融合植入件，其特征在于，所述植入件包括一种促进融合的材料。
30.一种用于插入多个用适合于人体移植的材料制成的部分圆筒形脊骨融合植入件的方法，所述多个植入件的每一个包括一圆筒体，圆筒体具有纵向中心轴线和与所述中心轴线平行的至少一个平侧面，所述植入件有一大于在两块脊椎骨之间的圆盘空间的最大直径，所述方法包括有以下的步骤：
钻出两个横穿在相邻两块脊椎骨之间的圆盘空间的部分重叠的圆筒形孔；
将有一第一平侧面的第一所述部分圆筒形脊骨融合植入件插入所述重叠圆筒形孔之一内，所述第一平侧面的方法是垂直于所述圆盘空间的平面；
将一有第二平侧面的第二所述部分圆筒形的值入件插入一第二所述重叠孔，所述第二平侧面邻近和面向所述第一植入件的所述第一平侧面。
31.一种用于将多个用适合人体移植的材料制成的部分圆筒形的脊骨融合植入件，所述多个植入件的每一个包括一圆筒体，圆筒体具有一纵向中心轴线和至少一个平行于所述中心轴线的平侧面，所述植入件有一大于在两块相邻的脊椎骨之间的圆盘空间的直径，所述圆盘空间是处在与所述脊柱的纵向垂直轴线相垂直的一个平面上，所述方法包括以下步骤：
钻出两个横穿在两相邻脊椎骨之间的圆盘空间的部分重叠的圆筒形孔；
将一具有第一平侧面的一第一所述部分圆筒形的脊骨融合植入件插入所述两重叠的圆筒形孔之一中，所述第一平侧面的方位是垂直于所述圆盘空间的平面；
将一具有第一平侧面的第一所述部分圆筒形的脊骨融合植入件插入所述两重叠的圆筒形孔之一中，所述第一平侧面的方位是垂直于所述圆盘空间的平面；
将一具有一第二平侧面的第二所述部分圆筒形植入件插进一第二所述重叠的孔中，所述第二平侧面邻近并面向所述第一植入件的所述第一平侧面。
32.一种用适合于人体移植的材料制成的部分圆筒形脊骨融合植入件，所述脊骨融合植入件包括一部分圆筒形部，部分圆筒形部具有被构成得可置放在紧靠第二部分圆筒形脊骨融合植入件的一外表面，所述第一和第二植入件在它们被置放在一起时具有小于所述第一和第二植入件的每一个的各自最大直径之和的一个组合总宽度。
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CN1954786B (zh) * 2005-10-26 2012-11-14 比德曼莫泰赫有限公司 带有一体回转接头的植入物
CN101715331A (zh) * 2007-02-09 2010-05-26 达美康公司 多凸起部的人造脊柱关节
CN101715331B (zh) * 2007-02-09 2014-03-26 达美康公司 多凸起部的人造脊柱关节
CN105287053A (zh) * 2015-10-30 2016-02-03 重庆医科大学附属永川医院 人工骨
CN109044519A (zh) * 2018-09-14 2018-12-21 北京爱康宜诚医疗器材有限公司 椎弓根螺钉

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