CN1725989B - 椎间盘植入物和用于插入植入物的插入工具 - Google Patents

椎间盘植入物和用于插入植入物的插入工具 Download PDF

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Publication number
CN1725989B
CN1725989B CN2003801060300A CN200380106030A CN1725989B CN 1725989 B CN1725989 B CN 1725989B CN 2003801060300 A CN2003801060300 A CN 2003801060300A CN 200380106030 A CN200380106030 A CN 200380106030A CN 1725989 B CN1725989 B CN 1725989B
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Prior art keywords
implant
recessed
draconis
insertion instrument
arm
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Expired - Fee Related
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CN1725989A (zh
Inventor
西尔赖·玛纳伊
鲁道夫·伯特阿格利
弗郎西斯·P·玛吉
斯蒂芬·埃克霍夫
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DePuy Spine LLC
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Spine Solutions Inc
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Abstract

一种椎骨间植入物(10),独立的和与用于插入植入物的插入工具(60)相接合的。植入物有上部分和下部分(11、30)这两部分限制与之相关的普通运动。上部分和下部分(11、30)带有与临近椎骨接合的表面。每部分都带有从所述表面延伸进入相邻椎骨中的豁口中的龙骨,并且每个龙骨带有开放的凹进。插入工具带有一对臂(61,71)被通过位于前部的开口被容纳在龙骨的凹进内以保证把握和插入植入物。在各个臂上的突出物(63,73)和相匹配的在凹进的底部的缺口(21,43)牢固的将各个臂附着在其龙骨中。

Description

椎间盘植入物和用于插入植入物的插入工具
技术领域
本发明涉及到椎间植入物,和特别的涉及到新的改良的椎骨间植入物及其插入工具和方法。
背景技术
以前,当必须完全从相邻的椎骨之间摘除椎间盘时,通常的治疗方法是将相邻的椎骨融合起来。最近,在椎间盘置换术的领域有了重要的发展,也就是椎间盘关节成型术包括插入人造椎间盘植入物到相连的椎骨之间的椎骨间隔中并且允许相邻的椎骨可以相对的弯曲,伸展,侧弯,轴向转动和平移,和吸收轴向压缩。
一种这样的发展是公布于2001年1月11日的,编号为No.WO 01/01893的公开申请中所描述的人造椎骨间植入物。用来植入的器械公布于2001年3月22日的编号为No.WO 01/19295的公开申请中。
这些申请中的椎骨间植入物和工具描述了本技术的实质性发展,但仍然需要在人造椎骨间植入物领域的继续改进。
这个领域所需要的进一步发展包括用于相邻的颈椎之间的椎骨间植入物。这是因为颈椎以及椎骨之间的空隙很小。例如颈椎表面的相对临近的颈椎之间的区域仅有腰椎相同表面的20%,因此使得这里是插入椎骨间植入物极其精细的区域。
发明内容
本发明的目标是提供一个新的,改进的椎骨间植入物,一种插入工具和插入方法,该方法在精细和安装困难的颈椎区域非常有利。需要指出的是,尽管本发明特别的在颈椎方面发展,但是本发明也同样适用与在脊椎的其他部分插入椎骨间植入物,包括腰椎。
这样,尽管本发明在已经发展并且为特别有利的在颈椎方面,下面的描述更加普通按照椎骨间植入物而并没有将其定义任何在脊椎上的特殊位置。
因此本发明的目标为提供一个新的改进的椎骨植入和插入工具和插入方法。
本发明的另一个目的是提供一种插入工具和插入新改进的椎骨间植入物的方法。
根据本发明,这里提供为了受限制的相对运动而操作性接合在一起的带有上部分和下部分的椎骨间植入物。带有龙骨的上部分被容纳在相邻近椎骨的豁口中,而带有龙骨的下部分被容纳在其他临近的椎骨的豁口中。依照本发明的主要特征,这些龙骨除了在临近的椎骨中起到固定的作用以外还包括在凹进一端的开口,用来接收插入工具的臂。这样设计的优点在于可以抓紧植入物并且在很局限的区域内使用插入工具将植入物插入椎骨间的工作区域的创口最小。
上部分优选的在其下表面带有球形凹进部分。下部分优选的带有附着于其上的塑料嵌入物,这个嵌入物带有突起的球形凸起部分,用来与上部分的球形凹进相结合来提供上下两部分之间受限制的普遍的相对运动。
与植入物结合使用插入工具的优选的带有一对臂,每个臂与龙骨上的一个凹进接合,每个臂带有突出,臂被向着凹进运动来实现与凹进底部上的缺口结合,从而牢固的把持植入物。臂还包含了侧面支撑部分,该侧面支撑部分与在上部分和下部分中的支撑豁口接合来吸收植入物的侧面受力以至于这样的侧面受力不会被定位在龙骨凹进部分的插入工具的臂上的更精细部分吸收。
本发明的方法包括使用已经描述的类型的插入工具与已经描述的类型的椎骨间植入物接合,伴随龙骨进入在相邻脊椎的豁口处,将椎骨间植入物插入到椎骨间隙中,并且将插入工具由椎骨间植入物中拿出,将椎骨间植入物留在椎骨间隙中。
这样,本发明的目标为提供一个新的改进的椎骨间植入物。
本发明的另外一个目标为提供用于插入新的改进的椎骨间植入物的插入工具和方法。
本发明的另外一个目标为提供一个特别的适合于颈椎的椎骨间植入物。
本发明的另一个目标为提供一个新的改进的椎骨间植入物其特点是突起的龙骨中有凹进用来接受用于插入椎骨间植入物的插入工具。
本发明的这些和其他目标将通过下面详细描述及附图被很清楚的了解。
附图说明
本发明的优选实施例将要结合附图进行描述,其中
图1本发明中椎骨间植入物的透视图;
图2是图1中插入物的前立面透视图;
图3是图1中插入物的左边立面透视图;
图4是沿图2中线4-4的横截面图;
图5是沿图3中线5-5的横截面图;
图6是图1中植入物上部分的顶视图;
图7是图1中植入物上部分的底表面底透视图;
图8是图1中植入物下部分的底视图;
图9是图1中植入物下部分的底部透视图;
图10是图1中植入物下部分的顶部透视图;
图11是图1中植入物的塑料镶嵌物的顶部透视图;
图12图1中植入物塑料镶嵌物的顶视图;
图13是图1中植入物塑料镶嵌物的底透视图;
图14-17是图1中插入物的立面透视图;描述关于其各部分之间限制的相对运动;
图18是一对准备在椎骨间缝隙安装本发明的植入物的相邻椎骨的示意图;
图19描述的是图18中的椎骨,沿图18中的线19-19方向并且显示植入物本身将要被插入和显示与植入物接合前的插入工具;
图20描述的是为本发明植入物使用的插入工具部分;
图21描述的是已插入植入物的图18中的椎骨和插入工具,插入工具持有植入物两者仍保持在插入过程中的相对位置,和
图22描述的是植入物安放到位并且插入工具已经移走后的椎骨。
具体实施方式
参考示图,在全部示图中相同的元件标注相同的号码。
在本发明中,词“较上”或“较下”或“最上”或“最下”或任何其他描述本发明椎骨植入物方位的词被使用仅仅是因为方便并不是要表达任何的限制。尤其是,植入物部分在本申请中描述的上部分实际可以被定位在病人脊椎的上面或下面部分两部分可以相互调换位置。同时,因为椎骨间植入物通常由病人的前方插入,脊椎的朝向椎骨植入物在被插入时运动的方向一边应该称为椎骨的前面并且相反的面就是后面并且左面和右面为侧面。因为普通的插入方式为前面,本发明将结合这个方位描述。同样,植入物的后面末端可以称为第一末端和植入物的前面末端可以称为第二末端。然而,应该懂得椎骨间植入物也能够由侧面插入,例如,从侧面,在这种情况下龙骨将要被定向在植入物上为了这样的侧面运动并且在相邻椎骨上的豁口也将朝向侧面来接收龙骨。
图1-5描述的是不同视角装配好的椎骨间植入物10包括上部分或部件11,下部分或部件30和塑料镶嵌物或插入物50定位在两者之间但是与下部分30相连。
本发明中介绍的椎骨间植入物主要是用于插入颈椎的。因为颈椎骨间的空间的直径相对较小,所以这个位置的椎骨需要精确。例如本发明的植入物,当在平面图中观察(由图6可以最好的观察)大概为12-16毫米宽和大概15-19毫米长。在实际操作中可以提供3种型号,12毫米×15毫米,14毫米×17毫米和16毫米×19毫米。植入物的高度,表示的是由上部分的上表面到下部分的下表面,排除龙骨,通常的在5毫米到9毫米之间。可以将这些尺寸与腰部区域的椎间盘作对比,其中矩形部分的尺寸为27到30毫米宽,34到39毫米长,其高度大概为10到14毫米。但是应该懂得本发明的特点同样可以适用于其他尺寸的和为其他部分椎骨包括腰部的结构设计。
上部11在此结合图1-5做以详细描述,图1-5描述的是安装好的植入物和图6和图7描述的只是上部分11。上部分11包括上表面或外侧面12与椎骨接合并支撑相连的椎骨表面。这个上表面12被稍稍带有斜面的边缘限制如13所示,沿着后表面带有这个斜面的最大部分。在倾斜边缘13的下面,上部分由周围的带有前面支撑豁口15的侧壁14所限制。因此,在附图中显示的龙骨由前向后龙骨的实心部分面向后面并且插入接合凹进结构面向前面。
上部分11的上表面12上方是龙骨16,龙骨16包括包括形成于其中的凹进部分17。缺口被向上面和前方张开。参考图4和图6,这个凹进部分包括在其底部部分的缺口21。龙骨16的后面结束部分包括V-型上面斜面19和V-型垂直部分20,组成“箭头”型的前部,如图6中显示。“箭头”型的用途是方便将龙骨插入形成于相邻近椎骨的豁口处。凹进部分的前方开口在18处向外张开,张开可用于将龙骨16的前方末端固定在其临近椎骨的豁口处。
上部分11包括下面平的内部表面24,其包括,如图7中显示的,突起的边缘26可以定义凹进的球形部分25。如图4和图5中所示,球形凹进部分25将与塑料镶嵌物50的上部凸出表面相接合。
下部分30参考图1-5被描述并且在图8-10中也显示了下部分30的单独示图。
下部分30包括下部椎骨支撑和接合表面或上表面31和内部上表面32。如图2,5和图10中显示的那样,下部分包括形成于表面32下方基础表面38上方的侧表面上的凹槽33和34。充分平坦的后壁35由底部表面38延伸至上表面32。这个下部分包括倾斜边缘36以及环绕的侧面39,倾斜边缘36沿着在其后面带有最显著斜面下部表面31的边缘延伸。凹进33和34的用途是容纳塑料镶嵌物50的侧面凸缘53和54,如在图11中显示的并且将于下面更加详细描述的那样。
下部分30包括前方支持豁口37。龙骨40从下表面31上向上升起(或在通常的方向,向下延伸)。这个龙骨包括向下和向前张开的缺口41以及包括在42带有一个向前方开口的通向凹进的入口,这个张开的入口提供与上部分11的入口18相同的功能,例如,方便龙骨的前方末端在椎骨的豁口中的接合。如图4中显示的,凹进部分41向下和向前张开并且包括缺口43。龙骨40包括在其后方末端的V-型下部斜面45和V-型垂直部分46两者结合组成“箭头“形状,在图8中描述的,方便龙骨插入相邻椎骨的豁口。如附图所示,凹进部分沿着植入物的前-后线张开。
参考图13,将要注意塑料镶嵌物50的下表面包括凸起的咬合突出部分57。现在参考图10,描述了适合于容纳咬合突出57的咬合凹进44,这样塑料镶嵌物能够固定在这里,防止移动。这个咬合装置也在图4中清楚显示。将要被注意的是,虽然,在通常状态下不能发生移动,实际上在后来是可能发生的,通过在下部分基础和塑料镶嵌物之间插入工具来将塑料镶嵌物撬起并将其移动。例如如果决定插入一个新的不同尺寸的塑料镶嵌物或需要修理以前的插入的塑料镶嵌物时,是很有用的。
上部分和下部分由适当的材料制成,如钛,钴铬钼,不锈钢或陶瓷。上部分的上表面和下部分的下表面与龙骨的旁边表面一样都有多孔钛涂层。这种多孔涂层在理论上允许血管生成和随着骨骼生长成骨细胞的形成。
在图1-5中所示的塑料嵌入物50,虽然,为方便起见没有将描述细节的数字在这些示图中标出,但是被表示在图11-13中。被优选的使用高密度的聚乙烯制作。图11描述的是塑料嵌入物50在图1中显示的位置上。包括平的上表面51,上表面51具有附着于其上的凸起的球形部分52,凸起的球形部分52与上部分11中的凹进的球形部分25紧密结合。侧面凸缘53和54接合在下部分30中的凹槽33和34。平的后壁55与下部分的后壁35接合。
参考图13,塑料嵌入物50包括接合下部分的底表面38的普通的平的下表面56和在倾斜在后边上的咬入突起部分57和包括在前边上有棱角的突出部分以至于可以抓紧底部表面38上的凹进44,如图4中显示的。
图14-17显示的是当被插入到病人的椎骨间空间中后插入物的上部和下部受限制的相对运动。图14和15,都是显示的嵌入物的前面视图,分别显示了最大的向左和向右的侧向弯曲。应该注意的是在各种情况下,上部分11的抬起的边缘26与下部分30的内表面相接合。在优选实施例中,相对于龙骨被垂直排列的参考位置,三个尺寸中较小的这样的侧弯运动能够达到接近10.5°和两个较大尺寸的可以接近8.9°。图16显示的是由病人的右边观察到的示图,表示的是上部分相对于下部分的延伸运动,下部分由边缘36与下部分30的内表面32相接合来限制下部分的运动。最后,图17,显示的是由病人左边观察到的示图,显示的是上部分11相对于下部分30的最大弯曲程度。弯曲受到嵌入物50的表面51与边缘26之间的接合的限制。在优选实施例中,三种型号中的较小的延伸和弯曲能够达到10.5°较大的两个可以达到近似于8.9°,相对于参考位置其中龙骨是垂直排列的。
图18-22描述的是在图1-17中显示的植入物的插入方法和操作工具部分,例如用来插入植入物的插入工具。
图18是一对在清理好的相对的椎骨间隙1中的相连椎骨V的前视图。在准备插入本发明的椎骨间植入物时,豁口c在椎骨V内成型。如图8和图19中左半部分所示的那样,这些豁口开始于椎骨的前面并且向着椎骨的后部延伸到最后但是不完全穿过,沿着其全部长度在椎骨的表面上横跨面向椎骨间空隙。
图19描述的是准备好的相邻的椎骨间植入物以图1-5中显示的那种形式。向右边其中是插入工具60参考图19和图20进行描述。这个插入工具60包括上臂61和下臂71,这些臂被排列运动朝向或远离对方如图19中的箭头B显示的那样。多种装置能够被用来移动这些臂朝向或远离对方。一种这样的剪刀模式的机械装置部分的显示为在图20中的80。上部和下部包括龙骨接合部分62和72分别的与凹进17和41接合。这些臂包括向着其外部末端突出部分63和73被建造来被分别被容纳在缺口21和43中。要注意的是这些龙骨相结合的部分62和72相对来说比较窄。事实上,设计中的这些龙骨的宽度为约2毫米,这样就允许实际的缺口小于2毫米。臂61和71也包括侧面支撑表面64和74,它们将工具和植入物接合起来,将与前面支撑豁口15和37接合。
臂61和71将被分开足够大使得突起63和73能够通过凹进17和41的底部直到达到缺口21和43,此时臂61和71将要被向着对方移动这样突起部分63和73接合在缺口21和43中并且侧面支撑表面64和74被接合豁口15和37中。在这个位置,上臂和下臂61和71的邻接表面65和75,分别的,将会相互邻接。
装配好的植入物这样附在插入工具上,伴随龙骨16和40进入豁口c插入工具将植入物移动进入椎骨间空隙,当龙骨后面的上面部分11和下面部分30的一部分的后部龙骨延伸进入椎骨间空间、超过豁口c,以至于上表面12接合相邻的椎骨V后面的椎骨间表面并且临近于龙骨16并且下部分30的表面31接合相邻的下部椎骨后面的椎骨间表面并且临近龙骨40。实际上,上面描述的插入工具60和预先备插入的植入物与图21中所示的相同,只是在插入后的。
应当注意到,在图21中,在龙骨凹进17和41内的臂61的上方和臂71的下方有缝隙,缝隙的垂直尺寸大于突出物63和73的高度,大概为1.2毫米。这是必要的臂61和71能够被分别的向上或向下移动,远离他们各自的凹进的底部以至于将突出物由缺口中释放出来,在臂61和71的上面和下面表面与椎骨在豁口C的垂直末端结合之前,这样的接触能够被避免。一旦这些臂因此被分开,他们能够从植入物中移出,先前的,植入物被留下来,如图22中显示的那样。
参考图18-22中描述的和显示本发明使用的方法将清楚的知道。参考本发明的方法,提供相邻的椎骨带有被描述样式的豁口以及所描述类型的椎骨间植入物被带有臂的插入工具抓紧,臂通过位于前部的开口被容纳在龙骨的缺口中。插入工具紧紧地抓住植入物,在龙骨的导向作用下植入物被在前面插入豁口直到达到正确的位置。此时,自然的一些力将作用来使两个相邻进的椎骨远离对方,但是优选的仅仅达到允许植入物插入的大小。事实上,许多专业人士更倾向于使两相邻椎骨间距离不大于上下表面12和31之间的基本宽度并且接下来使用棒槌或类似的工具来提供附加的外部力来完成植入物的插入。在植入物被插入后,插入工具臂被分开仅仅足够用于能够将突出物/缺口之间的接合松开,因此插入工具被移向前方,将植入物留在脊椎间并且解除先前用于分离相邻的椎骨的各种力允许这些椎骨依靠在植入物的上下支撑表面12和31上。
尽管本发明已经结合优选实施例作以详细描述,本专业内人士可以清楚的知道本发明能够在本发明的范围内有多种修改和变化。

Claims (50)

1.一种椎骨间植入物,包括
适合于与临近椎骨接合的上部分和适合于与相邻的椎骨接合的下部分,
上部分和下部分相互操作性接触,从而允许上部分和下部分相互之间受限制的普遍运动,
每一个上部分和下部分在其表面上都带有与临近椎骨相接合的隆起的龙骨,龙骨适合通过形成在椎骨前面的豁口被容纳在与其相邻的椎骨内,
并且每个在龙骨上具有形成凹进的侧壁,所述的凹进用于容纳插入工具。
2.根据权利要求1中所述的植入物,其中至少一个所述的凹进包括接合结构,用于与插入工具接合来保证工具不移出凹进。
3.根据权利要求2中所述的植入物,其中两个所述凹进都包括接合结构。
4.根据权利要求2中所述的植入物,其中接合结构包括在最靠近植入物的凹进的底部形成的并适合于容纳插入工具上的突出的缺口。
5.根据权利要求1中所述的植入物,其中龙骨的后部末端是倾斜的,从而便于龙骨进入豁口。
6.根据权利要求1中所述的植入物,其中龙骨在接近前部的开口处是向外张开的,以方便龙骨与邻近豁口的椎骨的前部相接合。
7.根据权利要求1中所述的植入物,植入物包括具有附着的塑料镶嵌物的下部分、向上的球形凸起部分和具有与球形凸起部分操作性接合的球形凹进部分的上部分。
8.根据权利要求7中所述的植入物,塑料镶嵌物被咬合在下部分内。
9.根据权利要求1中所述的植入物,其中上部分和下部分带有接近于龙骨凹进前部开口处的前部支撑豁口来容纳部分的插入工具。
10.一种组合的椎骨间植入物和用来插入植入物的插入工具,植入物包括适合于与相邻的椎骨接合的上部分和适合于与相邻的椎骨接合的下部分,
上部分和下部分相互操作性接触,以允许相对于对方的受限制的普通运动,
每一个上部分和下部分都带有表面凸起的、用于与邻近的椎骨相接合的龙骨,所述龙骨适合于通过形成于椎骨前面的豁口被容纳在与之相邻的椎骨里,
每个龙骨具有容纳插入工具的凹进,其中所述的凹进具有前部的开口,
并且所述的插入工具带有一对臂,与各个凹进通过凹进前部的开口相连接,从而抓紧植入物将其插入到椎骨间的空间。
11.根据权利要求10中所述的植入物和插入工具,至少一个凹进和其各自的插入工具带有补充接合结构用于将臂固定在凹进内。
12.根据权利要求11中所述的植入物和插入工具,其中补充接合结构包括臂上突起的突出物和与之相配的在其凹进底部上的缺口。
13.根据权利要求10中所述的植入物和插入工具,其中凹进和其各自的插入工具包括用于将臂固定在凹进内的补充接合结构。
14.根据权利要求10中所述的植入物和插入工具,其中上部分和下部分都带有邻近龙骨凹进开口的用于容纳部分的插入工具的前方支撑豁口,所述的臂带有用于插进其各自龙骨的凹进的第一狭窄部分和用于与前方支撑豁口相接合的第二宽阔部分。
15.根据权利要求10中所述的植入物和插入工具,其中插入工具可在进入和离开其各自的凹进的方向上移动,穿过前面的开口,并且在其垂直方向接合和释放其各自的植入物。
16.根据权利要求15中所述的植入物和插入工具,所说的插入工具带有临近的表面,临近的表面彼此相邻来限制两个臂的相对对方的运动。
17.根据权利要求15中所述的植入物和插入工具,包括在臂上凸起的突出物,突出物与相匹配的在其凹进底部的缺口接合用来将臂固定在其凹进内,并且其中各个臂的高度小于凹进的高度,容纳臂的凹进比臂的突起高度高很多,可以允许突起垂直运动离开缺口时臂不会向上移出其凹进。
18.一种椎骨间植入物,包括具有与临近椎骨接合的表面的上部分和具有与相邻的椎骨接合的表面的下部分,
所述上部分和下部分是分离的部分并非是相互完整连接的,而且所述上部分和下部分相互操作性接合以彼此相互运动,以及
上部分具有形成在上部分的表面上方的龙骨中的凹进,下部分具有形成在沿着下部分的表面延伸的龙骨中的凹进,其中所述的凹进容纳插入工具。
19.根据权利要求18所述的植入物,其中所述凹进面向前面。
20.根据权利要求18所述的植入物,其中所述凹进在上部分和下部分的每一个的表面中是向上和向前敞开的。
21.根据权利要求18所述的植入物,其中所述凹进包括接合结构。
22.根据权利要求21中所述的植入物,其中所述接合结构包括在最靠近植入物的凹进的底部形成的并适合于容纳操作工具上的突出的缺口。
23.根据权利要求18中所述的植入物,该植入物包括与上部分和下部分之一固定连接的插入物,并具有与其他的上部分和下部分的表面相配的表面,以提供上部分和下部分之间的相互运动。
24.根据权利要求18所述的植入物,其中所述上部分和下部分具有凸起的用于与邻近的椎骨相接合的龙骨,所述凹进在所述龙骨上形成。
25.根据权利要求24所述的植入物,其中所述龙骨上的凹进在上部分和下部分的每一个的表面中是向上面和向前面张开的。
26.根据权利要求24中所述的植入物,其中所述凹进包括接合结构。
27.根据权利要求26中所述的植入物,其中接合结构包括在最靠近植入物的凹进的底部形成的并适合于容纳操作工具上的突出的缺口。
28.根据权利要求24中所述的植入物,所述龙骨具有第一末端,该第一末端沿着植入物的运动方向引入到椎骨间隙空隙中,和与第一末端相对的第二末端,其中龙骨在所述第一末端倾斜。
29.根据权利要求28中所述的植入物,其中龙骨在接近所述第二末端的开口处是向外张开的,以方便龙骨容纳操作工具。
30.根据权利要求24所述的植入物,其中所述凹进面向前面。
31.根据权利要求18所述的植入物,包括位于上部分和下部分之间的插入物,插入接合上部分和下部分以致允许上部分和下部分之间受限制的相互运动。
32.根据权利要求31所述的植入物,所述插入物与上部分和下部分之一固定连接,并具有与其他的上部分和下部分的表面相配的表面,以提供所述的上部分和下部分之间的相互运动。
33.根据权利要求18中所述的植入物,其中所述上部分和下部分都包括所述凹进。
34.根据权利要求33所述的植入物,其中所述上部分和下部分具有凸起的用于与邻近的椎骨相接合的龙骨,以及其中所述龙骨都具有在龙骨上形成的凹进。
35.根据权利要求34所述的植入物,其中所述龙骨上的凹进在上部分和下部分的每一个的表面中是向上和向前张开的。
36.根据权利要求33所述的植入物,包括位于上部分和下部分之间的插入物,插入接合上部分和下部分以提供上部分和下部分之间受限制的相互运动。
37.根据权利要求36所述的植入物,所述插入物与上部分和下部分之一固定连接,并具有与其他的上部分和下部分的表面相配的表面,以提供所述的上部分和下部分之间的相互运动。
38.一种用于椎骨间植入物的部件,该部件适于与至少一个其他部件结合以形成椎骨间植入物,该部件包括:
适合与临近椎骨相接合的上表面,和适合与植入物的其他部件有效接合的下表面,以及
在所述部件的上表面上形成的凹进,该凹进用于容纳插入植入物的插入工具。
39.根据权利要求38所述的部件,其中所述凹进包括接合结构。
40.根据权利要求39中所述的部件,其中接合结构包括在凹进的底部形成的并适合于容纳操作工具上的突出的缺口。
41.根据权利要求38所述的部件,其中所述部件包括凸起的用于与邻近的椎骨相接合的龙骨,以及其中所述凹进在龙骨上形成。
42.根据权利要求41所述的部件,其中所述龙骨上的凹进在部件中是向上和向前敞开的。
43.根据权利要求42中所述的部件,其中龙骨具有第一末端,该第一末端沿着植入物的运动方向引入到椎骨间空隙中,和与第一末端相对的第二末端,以及龙骨在所述第一末端倾斜。
44.根据权利要求43中所述的部件,其中龙骨在接近第二末端的开口处是向外张开的,以方便龙骨容纳操作工具。
45.一种椎骨间植入物和用于将植入物插入到椎骨间空隙中的插入工具的组合,
所述植入物具有有与相邻椎骨接合的表面的上部分和有与相邻椎骨接合的表面的下部分,其中上部分和下部分相互操作性接合,以彼此受限制的相互运动,
所述上部分和下部分的每一个都具有凹进,所述凹进在所述上部分和下部分的表面上形成,而且大小和形状适于容纳插入工具。
46.根据权利要求45中所运的组合,其中每一部分都具有所述凹进,而且所述插入工具具有成对的臂,一个臂的形状与每一个凹进相配。
47.根据权利要求45中所述的组合,其中上部分和下部分具有凸出的龙骨和在所述龙骨上形成的凹进。
48.根据权利要求47中所述的组合,其中每一龙骨都具有在龙骨上形成的凹进,而且所述插入工具具有成对的臂,一个臂的形状与每一个凹进相配。
49.根据权利要求47中所述的组合,其中所述龙骨上的凹进具有前面末端和后面末端,所述凹进在前面末端上是敞开的。
50.根据权利要求49中所述的组合,其中所述插入工具的形状可以使经过前面的开口从所述凹进中移出。
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US8579978B2 (en) 2013-11-12
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