CN1925817A - 混合的椎间盘系统 - Google Patents

混合的椎间盘系统 Download PDF

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Publication number
CN1925817A
CN1925817A CNA2005800065791A CN200580006579A CN1925817A CN 1925817 A CN1925817 A CN 1925817A CN A2005800065791 A CNA2005800065791 A CN A2005800065791A CN 200580006579 A CN200580006579 A CN 200580006579A CN 1925817 A CN1925817 A CN 1925817A
Authority
CN
China
Prior art keywords
core component
vertebral implant
board assembly
end board
vertebral
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.)
Pending
Application number
CNA2005800065791A
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English (en)
Inventor
H·H·特里优
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.)
Warsaw Orthopedic Inc
Original Assignee
SDGI Holdings Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by SDGI Holdings Inc filed Critical SDGI Holdings Inc
Publication of CN1925817A publication Critical patent/CN1925817A/zh
Pending legal-status Critical Current

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Abstract

一插入在两个椎骨端板之间的椎骨移植物包括一用来接合第一椎骨端板的第一端板组件、一用来接合第二椎骨端板的第二端板组件，以及一插入在第一和第二端板组件之间的第一柔性核心部件。第一柔性核心部件包括第一和第二端部。第一端部偶联到第一端部组件以防止第一端部相对于第一端板组件平移，而第二端部相对于第二端板组件可枢转。

Description

混合的椎间盘系统
背景技术
在过去的三十年中，大关节再造装置设计方面的技术进步使得关节退变疾病的治疗发生翻天覆地的变化，治疗标准从关节固定术转变到关节造形术。然而，椎骨盘疾病治疗的进步步伐已变得缓慢起来。目前，盘疾病的标准治疗仍然是盘切除后实施椎骨的融合。尽管该方法可减轻病人目前的症状，但由融合诱发运动和力的增加，其结果，常加速邻近盘的退变。因此，对于许多病人来说，用一功能性的盘假体，再造退变的椎间盘以提供运动和减小邻近盘的恶化，可能是更为理想的治疗选择。
发明内容
在一实施例中，插入在两个椎骨端板之间的椎骨移植物包括一用来接合第一椎骨端板的第一端板组件、一用来接合第二椎骨端板的第二端板组件，以及一插入在第一和第二端板组件之间的第一柔性核心部件。第一柔性核心部件包括第一和第二端部。第一端部偶联到第一端部组件以防止第一端部相对于第一端板组件平移，而第二端部相对于第二端板组件可枢转。
在另一实施例中，椎骨移植物包括一第二柔性核心部件。
在另一实施例中，椎骨移植物包括至少一个在第一和第二端板组件之间延伸的系带以便约束移植物。
在另一实施例中，椎骨移植物包括一变态元件以便修改核心部件的柔性。
在另一实施例中，用来插入在两个椎骨端板之间的椎骨移植物包括一用来接合第一椎骨端板的第一端板组件、一用来接合第二椎骨端板的第二端板组件，以及一插入在第一和第二端板组件之间的第一柔性核心部件。第一柔性核心部件包括一外表面，其中，外表面包括一关节连接的表面，其没有覆盖到全部的外表面。第一端板组件包括一偶联机构，它的形状适于匹配第一柔性核心部件的轮廓。
附图的简要说明
图1是具有一损坏盘的脊椎的径向视图。
图2是具有一替换损坏盘的椎间盘假体的脊椎的径向视图。
图3是根据本发明第一实施例的一分解的椎间盘假体的侧视截面图。
图4是根据本发明第一实施例的一组装的椎间盘假体的侧视截面图。
图5是根据本发明第一实施例的椎间盘假体的俯视截面图。
图6是椎间盘假体的一端板部分的侧视图。
图7是椎间盘假体的一端板部分的前视图。
图8是椎间盘假体的一端板部分的侧视图。
图9是椎间盘假体的一端板部分的前视图。
图10是椎间盘假体的一端板部分的侧视图。
图11-13是根据本发明替代实施例的椎间盘假体的俯视截面图。
图14-18是根据本发明替代实施例的椎间盘假体的侧视截面图。
图19是根据本发明一替代实施例的分解的椎间盘假体的侧视截面图。
图20是根据图19的实施例的组装椎间盘假体的侧视截面图。
图21是根据图19的实施例的椎间盘假体的俯视截面图。
图22-30是根据本发明替代实施例的组装椎间盘假体的侧视截面图。
图31是根据本发明一替代实施例的椎间盘假体的侧视截面图。
图32是根据图31的实施例的椎间盘假体的俯视截面图。
图33是根据本发明一替代实施例的椎间盘假体的侧视截面图。
图34是根据图33的实施例的椎间盘假体的俯视截面图。
图35、37、39和41是根据本发明替代实施例的椎间盘假体的俯视截面图。
图36、38、40和42分别是图35、37、39和41的实施例的椎间盘假体的侧视截面图。
具体实施方式
本发明一般地涉及椎骨再造装置，具体来说，涉及一功能性的椎间盘假体。为了便于理解本发明的原理，现将参照附图中所示的实施例或实例，并用特殊的语言来描述它们。然而，应该理解到，由此并不意图限制本发明的范围。在所述实施例中的任何替代和进一步的修改，以及如本文中所述的本发明原理的任何进一步应用，对于本发明所涉及的技术领域内的技术人员来说，应认为是正常发生的。
首先参照图1，标号10表示一具有在两个完好椎骨14和16之间延伸的损坏椎间盘12的脊柱。在一典型的外科切除术中，损坏盘12被除去，在两个完好椎骨14和16之间形成一空穴。该手术程序执行可使用一前向、前侧向、侧向方法，或本技术领域内的技术人员熟知的其它的方法。
现参照图2，可提供一假体18来填充椎骨14和16之间的空穴。
现参照图3-5，一椎间盘假体20可用作为图2的假体18。根据本发明一实施例的椎间盘假体20包括端板组件22、24和一核心部件26。端板组件22可包括一外表面28和一内表面30。在此实施例中，表面30可相对平坦和光滑，并可具有一光滑的镜面表面。表面30还可包括一槽32。端板组件24可具有一外表面34和一内表面36。表面36可相对平坦和光滑，并可具有一光滑的镜面表面。表面36还可包括一诸如一槽那样的偶联机构37。关节的内表面30、36可以平坦且具有如本实施例中所示的镜面，然而，在替代的实施例中，关节的表面可包括槽、凹坑或其它特征，以便提高润滑性能并减小摩擦和磨损。这些表面可用任何的各种技术予以处理以提高耐磨性，例如，离子注入、金刚石或金刚石状的涂敷，或能使表面比原来表面更加坚硬的其它方法。
核心部件26可包括一具有端表面40和42的柔性本体38。如图5所示，从一垂直于纵向轴线44(图3)的平面观看，核心部件26可具有一大致圆形的截面。可要求有替代的横截面形状，在一单一核心部件26中，横截面形状可根据垂直平面的位置变化。在此实施例中，端表面40和42可以相对地平坦和平行，并可分别地包括偶联机构46、48，它们可以是突脊。端表面40、42可与柔性本体38一体形成，或可用机械方法或粘结方法附连到柔性本体38。例如，如图4所示，一诸如突脊那样形成在柔性本体38上的偶联机构50可接合一诸如槽那样形成在端表面42上的偶联机构52。在替代的实施例中，核心部件可具有弧形端表面或相对于彼此倾斜的端表面。
端板组件22、24可以由任何合适的生物相容材料形成，包括有诸如钴铬合金、钛合金、镍钛合金之类的金属，和/或不锈钢合金。诸如氧化铝或矾土之类的陶瓷、氧化锆或锆土、特殊金刚石压块，和/或热解碳等也可适用。也可使用聚合物材料，包括任何数量的多芳基酮醚(PAEK)族，诸如聚醚酮醚(PEEK)、碳强化的PEEK，或聚醚酮醚酮醚(PEKK)；聚砜；聚醚酰亚胺；聚酰亚胺；超高分子量聚乙烯(UHMWPE)；和/或交连的UHMWPE。
外表面28、34可包括特征或涂层(未示出)，它们提高移植的假体的固定能力。例如，表面可以粗糙化，例如，通过化学蚀刻、喷丸、砂纸打磨、磨削、刻齿纹，和/或金刚石切割。所有的或一部分的外表面28、34也可涂敷生物相容的和骨传导的材料，诸如羟磷灰石(HA)、磷酸三钙(TCP)，和/或碳酸钙，以促进骨的生长和固定。或者，可使用骨传导涂层，诸如取自转化生长因子(TGF)β总科的蛋白质，或骨形态基因蛋白质，诸如BMP2或BMP7。其它合适的特征可包括用于初始固定的图6中端板组件60上所显示的长钉、图7和8中端板组件62上所显示的突脊或龙骨，以防止沿侧向和前方向的迁移，例如，图9和10中的端板组件64上所示的锯齿形或金刚石切割表面；翅片；短柱；和/或其它表面纹理。
再次参照图3-5，柔性本体38可由一个或多个弹性材料形成，其具有比端板材料小的弹性模量。合适的材料可包括聚合物的弹性体，诸如聚烯烃橡胶；聚亚胺酯(包括聚醚聚氨酯、聚碳酸脂聚氨酯，以及聚亚胺酯，具有或没有表面修改的端板)；具有或没有表面修改的端板的硅树脂和聚亚胺酯的共聚物；硅树脂；以及水凝胶。聚异丁烯橡胶、聚异戊二烯橡胶、氯丁橡胶、丁腈橡胶，和/或5-甲基-1，4-己二烯的硫化橡胶也是合适的。
核心部件端表面40、42可以修改、处理、涂敷或内衬以提高核心部件26的耐磨性和关节特性。这些耐磨性和关节特性可由钴铬合金、钛合金、镍钛合金，和/或不锈钢合金提供。诸如氧化铝或矾土之类的陶瓷、氧化锆或锆土、特殊金刚石压块，和/或热解碳等也可适用。也可使用聚合物材料，包括任何数量的多芳基酮醚(PAEK)族，诸如聚醚酮醚(PEEK)、碳强化的PEEK，或聚醚酮醚酮醚(PEKK)；聚砜；聚醚酰亚胺；聚酰亚胺；超高分子量聚乙烯(UHMWPE)；和/或交连的UHMWPE。聚烯烃橡胶、聚亚胺酯、硅树脂和聚亚胺酯的共聚物，以及水凝胶也可提供耐磨性和关节特性。通过诸如交连的和金属离子注入的修改，耐磨特性也可以或替代地提供给端表面40、42。
尽管图3-5的实施例描述了圆形的端板组件，但图11示出了一矩形的端板组件66。图12示出一带有弧形侧的矩形端板组件68。图13示出一腰子形或心形的端板组件70。其它端板几何形可以是正方形、椭圆形、三角形、六角形，或任何其它形状。如图5的俯视横截面图所示，核心部件的几何形可以是圆形、椭圆形，或促进约束或关节连接的任何其它形状。
在图3-5的实施例中，外表面28和34可以相对地平行，但在其它实施例中，表面可以相对于彼此倾斜以容纳一特殊的脊柱前凸或前弯角。如图14-18所示，假体可以是锥形、倾斜，或楔形以便达到一理想的脊柱前凸或前弯角。这样的角度可以通过包括倾斜的端板组件和/或核心部件而形成。图14的假体72结合一倾斜端板而呈倾斜。而图15的假体74通过包括两个倾斜端板而呈倾斜。图16的假体76通过包括带有一具有一倾斜侧的核心部件的平的端板而呈倾斜。图17的假体78通过包括带有一具有两个倾斜侧的核心部件的平的端板而呈倾斜。图18的假体80通过包括一倾斜端板和具有一个倾斜侧的核心部件而呈倾斜。
再次参照图4，假体20可通过核心部件26的突脊46、48分别与端板组件的槽32、37接合进行组装。组装的假体20可以移植到脊柱10(图1)内的通过移去盘12而形成的空穴内，以使外表面28接合椎骨体14的端板，而外表面34接合椎骨体16的端板。
在手术中，假体20可在平行于纵向轴线44的压缩载荷下弹性地变形，并可响应于沿纵向轴线44拉端板组件彼此远离的力而弹性地伸展。假体20也可在弯曲延伸下变形或侧向地弯曲移动。核心部件26可允许一可变的转动中心以作弯曲延伸和侧向弯曲移动。核心部件26的柔软特性也可减小在弯曲延伸和侧向弯曲移动中由横向剪切或关节连接造成的磨损。核心部件26也可弯曲以允许端板组件22相对于端板组件24作前-后或侧向的平移。此外，端表面40、42和内表面30、36之间的接触面相应地转动不受约束，核心部件26可围绕纵向轴线44枢转或转动。然而，接触面可以约束接触面处的平移运动。端板组件22、24也可相对于彼此转动。在替代的实施例中，端表面40、42和内表面30、36之间的至少一个接触面对应地可允许不转动或枢转运动。核心部件26的偶联机构46、48与偶联机构32、37的接合可防止核心部件26的弹出，同时允许端板组件22、24相对于核心部件转动。
现参照图19-21，一椎间盘假体90可用作为图2的假体18。根据本发明的一实施例，椎间盘假体90包括端板组件92、94和一核心部件96。端板组件92可包括一外表面98和一内表面100。在此实施例中，内表面100可以相对地呈凹陷和光滑并可具有一镜面光滑的表面。端板组件94可具有一外表面104和一内表面106。表面106可以相对地呈凹陷和光滑并可具有一镜面光滑的表面。在此实施例中，外表面98和104相对地平行，但在其它实施例中，如上所述，诸表面可相对于彼此倾斜以容纳一特殊的脊柱前凸或前弯角。
核心部件96可包括一具有端表面110和112的柔性本体108。如图21所示，当从一垂直于纵向轴线44的平面观看时，核心部件96可具有一大致圆形的截面。也可要求有替代的其它横截面形状，在单一核心部件96中，横截面形状可根据垂直平面的位置而变化。在此实施例中，表面110和112可以相对地呈凸出。端表面110、112可以与柔性本体118一体形成，或可机械地或粘结地附连到柔性本体118。例如，诸如一形成在柔性本体108上的突脊那样的偶联机构114可接合诸如形成在端表面112上的槽那样的偶联机构116。
端板组件92、94可分别用与端板组件22、24相同或类似的材料形成，包括相同的或类似的特征或涂层。同样地，核心部件96可用如上对于核心部件26所述的相同材料形成并可包括相同的耐磨性。假体90；端板组件92、94；以及核心部件96可形成上述图6-18中的形状。
如图20所示，假体90可通过分别定位与内表面100、106接触的端表面110、112进行组装。组装的假体90可植入到由移去盘12而形成的空穴内的脊柱10内(图1)，以使外表面98接合椎骨体14的端板，而外表面104接合椎骨体16的端板。
在手术中，假体90可在平行于纵向轴线44的压缩载荷下弹性地变形。假体90也可在弯曲延伸下变形或侧向地弯曲移动。核心部件96也可弯曲以允许作前后或侧向平移移动。核心部件96可允许一可变的转动中心以作弯曲延伸和侧向弯曲移动。核心部件96的柔软特性也可减小在弯曲延伸和侧向弯曲移动中由横向剪切或关节连接造成的磨损。此外，由于端表面110、112和内表面100、106之间的接触面相应地不受约束，核心部件96可围绕纵向轴线44转动。端板组件92、94也可相对于彼此转动。凹陷的内表面100、106可防止核心部件26的弹出，同时允许端板组件22、24相对于核心部件转动。
如图22-27所示，各种替代的端板组件、核心部件以及偶联机构的设计可限制侧向的平移，同时允许轴向的转动。例如，现参照图22，一椎间盘假体120可用作为图2的假体18。椎间盘假体120包括端板组件122、124和一核心部件126。端板组件122、124可包括相应的外表面128、130和内表面132、134。内表面132、134可包括凹陷和凸出的部分并可如一镜面表面那样地光滑。凹陷和凸出部分可在内表面上形成同心环。在图22的实施例中，内表面132、134的凸出部分136、138可起作偶联机构。端板组件122、124可分别用与端板组件22、24相同的或类似的材料形成，包括相同的或类似的特征或涂层。
核心部件126可包括一具有端表面142、144的柔性本体140。在此实施例中，端表面142、144可包括偶联机构146、148，它们可以是近似位于端表面中心内的凹坑。核心部件126可用对于核心部件26所述的相同材料形成，并可包括如上相同耐磨特性。
假体120可通过分别定位与内表面132、134接触的端表面142、144进行组装。具体来说，端板组件的偶联机构136、138可接合核心部件的偶联机构146、148。组装的假体120可植入到由移去盘12而形成的空穴内的脊柱10内(图1)，以使外表面128接合椎骨体14的端板，而外表面130接合椎骨体16的端板。
现参照图23，一椎间盘假体150可用作为图2的假体18。椎间盘假体150包括呈圆形的端板组件152、154和一核心部件156。端板组件152、154可分别包括外表面158、160和内表面162、164。与图22实施例相同，内表面162、164可包括凹陷和凸出部分，并可如镜面那样光滑。凹陷和凸出部分可在内表面上形成同心环。在此实施例中，内表面162、164的凸出环部分166、168可起作偶联机构，以对应地接合形成在核心部件156的端表面174、176上的凹陷的偶联机构170、172。
现参照图24，一椎间盘假体180可用作为图2的假体18。根据本发明的该实施例，假体180包括端板组件182、184和一核心部件186。端板组件182、184可分别包括外表面188、190和内表面192、194。内表面192、194可包括凹陷和凸出部分，并可如镜面那样光滑。在图24的实施例中，内表面192、194的凸出环部分196、198可起作偶联机构。端板组件182、184可对应地用与端板组件22、24相同的或类似的材料形成，包括相同的或类似的特征或涂层。
核心部件186可包括一具有关节表面202的柔性本体200。在此实施例中，端板组件186可以呈环的形状，具有一中心孔204，其可起作一偶联机构。核心部件186可用以上对于核心部件26所述的相同材料形成，并可包括相同的耐磨特性。
假体180可通过分别定位与内表面190、194之间的核心部件196进行组装。具体来说，端板组件的偶联机构196、198可接合核心部件的偶联机构204。组装的假体180可植入到由移去盘12而形成的空穴内的脊柱10内(图1)，以使外表面188接合椎骨体14的端板，而外表面192接合椎骨体16的端板。
在手术中，关节表面202和内表面190、194之间的接触面可允许围绕纵向轴线44转动和有限的侧向平移。假体180可在平行于纵向轴线44的压缩载荷下弹性地变形以吸收冲击和提供阻尼作用。端板组件182、184和核心部件186之间的关节接触面，以及柔性本体200的弹性可允许作弯曲延伸和侧向弯曲运动。
现参照图25，一椎间盘假体210可用作为图2的假体18。根据本发明的该实施例，椎间盘假体210包括端板组件212、214和一核心部件216。端板组件212可分别包括一外表面218和一内表面220。在图25的实施例中，内表面220可相对地凹陷和光滑，并可具有镜面那样光滑。端板组件214可具有一外表面222和一内表面224。内表面224可以相对地凹陷并可包括一偶联机构226，该机构可以是一突出的短柱。
核心部件216可包括一柔性层228和附连到柔性层228的外关节层230、232。关节层230可以是凸出的。关节层232可大致地呈凸出，并可包括一用作为偶联机构的凹陷234。在一替代的实施例中，凹陷可以形成在关节层230上。
端板组件212、214可对应地用与端板组件22、24相同的或类似的材料形成，包括相同的或类似的特征或涂层，因此不再作详细的描述。柔性层228可用与以上对于核心部件26所述的相同的柔性或弹性材料形成。关节层230、232可用与端板组件22、24相同或类似的材料形成。或者，关节层230、232可用与以上对于核心部件26所述的相同或类似的材料形成，仅在交连或离子注入方面有修改以提高耐磨性能。
如图25所示，假体210可通过端板组件212的凹陷内表面220与核心部件216的凸出关节层230的接合进行组装。通过偶联机构234接合偶联机构226，关节层232可接合端板组件214的内表面224。
在手术中，凸出的关节表面230和端板组件212的凹陷表面220之间的接触面可允许围绕纵向轴线44转动和有限的侧向平移。关节层232可允许围绕内表面224的偶联机构226转动，同时允许核心部件216和端板组件214之间很小或没有侧向平移。假体210可在平行于纵向轴线44的压缩载荷下弹性地变形以吸收冲击和提供阻尼作用。端板组件212和核心部件216之间的关节接触面，以及柔性层228的弹性可允许作弯曲延伸和侧向弯曲运动，或围绕纵向轴线44作轴向转动。
现参照图26，一椎间盘假体240可用作为图2的假体18。根据本发明的该实施例，椎间盘假体240包括端板组件242、244和一核心部件246。端板组件242可分别包括一外表面248和一内表面250。在图26的实施例中，内表面250可相对地凹陷和光滑，并可具有镜面那样光滑。
端板组件244可具有一外表面252和一内表面254。内表面254可以相对地平坦并可包括一偶联机构256，该机构可以是一突出的短柱，而偶联机构258可以是一槽。
核心部件246可包括一柔性层260和附连到柔性层260的外关节层262、264。关节层262可以是凸出的。关节层264可相对地呈平坦，并可包括一突脊266和一凹坑268，它们两个可用作为偶联机构。
端板组件242、244可对应地用与端板组件22、24相同的或类似的材料形成，包括相同的或类似的特征或涂层，因此不再作详细的描述。柔性层260可用与以上对于核心部件26所述的相同的柔性或弹性材料形成。关节层262、264可用与端板组件22、24相同或类似的材料形成。或者，关节层262、264可用与以上对于核心部件26所述的相同或类似的材料形成，仅在交连或离子注入方面有修改以提高耐磨性能。
如图26所示，假体240可通过端板组件242的凹陷内表面250与核心部件246的凸出关节层262的接合进行组装。通过偶联机构266、268分别接合偶联机构258、256，关节层264可接合端板组件244的内表面254。
在手术中，凸出的关节层262和端板组件242的凹陷表面250之间的接触面可允许围绕纵向轴线44转动和有限的侧向平移。关节层264可允许围绕轴线44相对于内表面254转动，或者，接触面可以机械地或粘结地固定到本转动。假体240可在平行于纵向轴线44的压缩载荷下弹性地变形以吸收冲击和提供阻尼作用。端板组件242和核心部件246之间的关节接触面，以及柔性层262的弹性可允许作弯曲延伸和侧向弯曲运动，或围绕纵向轴线44作轴向转动。
现参照图27，一椎间盘假体270可用作为图2的假体18。根据本发明的该实施例，椎间盘假体270包括端板组件272、274和一核心部件276。端板组件272可分别包括一外表面278和一内表面280。在图27的实施例中，内表面280可包括呈同心圆、燕尾槽的偶联机构282。
端板组件274可具有包括一外表面284和一内表面286。内表面286可相对地光滑和凹陷，并可具有镜表面的光滑。
核心部件276可包括一柔性层288和附连到柔性层290的外关节层290、292。关节层292可以是凸出的。关节层290可包括平坦部分，并可包括呈同心圆、燕尾形突出的偶联机构294。
端板组件272、274可对应地用与端板组件22、24相同的或类似的材料形成，包括相同的或类似的特征或涂层。柔性层288可用与以上对于核心部件26所述的相同的柔性或弹性材料形成。关节层290、292可用与端板组件22、24相同或类似的材料形成。或者，关节层290、292可用与以上对于核心部件26所述的相同或类似的材料形成，仅在交连或离子注入方面有修改以提高耐磨性能。
如图27所示，假体270可通过端板组件274的凹陷内表面286与核心部件276的凸出关节层292的接合进行组装。通过偶联机构282接合偶联机构294，关节层290可接合端板组件272的内表面280。
在手术中，凸出的关节层292和端板组件274的凹陷表面286之间的接触面可允许围绕纵向轴线44转动和有限的侧向平移。关节层290可允许围绕轴线44相对于内表面280转动，同时，偶联机构282、294阻止或限制侧向运动。假体270可在平行于纵向轴线44的压缩载荷下弹性地变形以吸收冲击和提供阻尼作用。端板组件274和核心部件276之间的关节接触面，以及柔性层288的弹性可允许作弯曲延伸和侧向弯曲运动，或围绕纵向轴线44作轴向转动。在一替代的实施例中，诸如用于标号282、294的偶联机构可用于端板组件274和核心部件276之间的接触面。在此替代实施例中，侧向平移可被阻止或限制，而仍允许围绕轴线44转动。在此替代实施例中的核心部件的柔性仍可作弯曲延伸和侧向弯曲运动。
现参照图28，一椎间盘假体300可用作为图2的假体18。根据本发明的另一实施例，椎间盘假体300包括端板组件302、304和一核心部件306。端板组件302可包括一外表面308和一内表面310。在图28的实施例中，内表面310可以是相对的凹陷和光滑，并具有镜面那样的光滑。
端板组件304可具有一外表面314和一内表面316。内表面316可相对地平坦，并可包括一呈槽的偶联机构318。外表面308和314可相对地平行和相对于彼此倾斜，以容纳特殊的脊柱前凸或前弯角。
核心部件306可包括一柔性层320和一附连到柔性层320的关节层322。关节层322可具有一凸出表面324。柔性层320可包括呈突脊的一偶联机构326。核心部件306可具有一大致圆形的横截面(如从一垂直于纵向轴线44的平面观看)。替代的横截面形状也是理想的，在一单一的核心部件306中，横截面形状可以根据垂直平面的位置变化。
端板组件302、304可对应地用与端板组件22、24相同的或类似的材料形成，包括相同的或类似的特征或涂层，因此，不再作详细的描述。柔性层320可用与以上对于核心部件26所述的相同的柔性或弹性材料形成。关节层322可用与端板组件22、24相同或类似的材料形成。或者，关节层322可用与以上对于核心部件26所述的相同或类似的材料形成，仅在交连或离子注入方面有修改以提高耐磨性能。
如图28所示，假体300可通过机械地或粘结地将柔性层320附连到端板组件304的内表面316进行组装。偶联机构318可接合偶联机构326，提供机械的附连。附加地或替换地，可使用一粘结剂来附连柔性层320和内表面316。关节层322的凸出表面324可定位在凹陷的内表面310上。组装的部件302-306可植入到由移去盘12而形成的空穴内的脊柱内(图1)，以使外表面308接合椎骨体14的端板，而外表面314接合椎骨体16的端板。
在手术中，关节层322的凸出表面324可与端板组件92的凹陷表面310形成关节连接。假体300可在平行于纵向轴线44的压缩载荷下弹性地变形以吸收冲击和提供阻尼作用。端板组件302和核心部件306之间的关节接触面，以及柔性层320的弹性可允许作弯曲延伸和侧向弯曲运动，或围绕纵向轴线44作轴向转动。端板组件302、304也可相对于彼此转动。
现参照图29，一椎间盘假体330可用作为图2的假体18。根据本发明的另一实施例，椎间盘假体330包括端板组件332、334和一核心部件336。端板组件332可包括一外表面338和一内表面340。在图16的实施例中，内表面340可以是相对的平坦，并包括一可以是槽的偶联机构342。
端板组件334可具有一外表面344和一内表面346。内表面346可以至少部分地凸出并可如镜面那样光滑。外表面338和344可相对地平行或可相对于彼此倾斜，以容纳特殊的脊柱前凸或前弯角。
核心部件336可包括一柔性层350和一附连到柔性层350的关节层352。关节层352可具有一凹陷表面354。柔性层350可包括呈突脊的一偶联机构356。核心部件336可具有一大致圆形的横截面(如从一垂直于纵向轴线44的平面观看)。替代的横截面形状也是理想的，在一单一的核心部件336中，横截面形状可以根据垂直平面的位置变化。
端板组件332、334可对应地用与端板组件22、24相同的或类似的材料形成，包括相同的或类似的特征或涂层，因此，不再作详细的描述。柔性层350可用与以上对于核心部件26所述的相同的柔性或弹性材料形成。关节层352可用与端板组件22、24相同或类似的材料形成。或者，关节层352可用与以上对于核心部件26所述的相同或类似的材料形成，仅在交连或离子注入方面有修改以提高耐磨性能。
如图29所示，假体330可通过机械地或粘结地将柔性层350附连到端板组件332的内表面340进行组装。偶联机构342可接合偶联机构356，提供机械的附连。附加地或替换地，可使用一粘结剂来附连柔性层350和内表面340。关节层352的凹陷表面354可定位在凸出的内表面346上。组装的部件332-336可植入到由移去盘12而形成的空穴内的脊柱10内(图1)，以使外表面338接合椎骨体14的端板，而外表面344接合椎骨体16的端板。
在手术中，关节层352的凹陷表面354可与端板组件334的凸出表面346形成关节连接。假体330可在平行于纵向轴线44的压缩载荷下弹性地变形以吸收冲击和提供阻尼作用。端板组件334和核心部件336之间的关节接触面，以及柔性层350的弹性可允许作弯曲延伸和侧向弯曲运动，或围绕纵向轴线44作轴向转动。端板组件332、334也可相对于彼此转动。
现参照图30，一椎间盘假体360可用作为图2的假体18。根据本发明的另一实施例，椎间盘假体360包括端板组件362、364、一核心部件366和一核心部件367。端板组件362可包括一外表面368和一内表面370。在图30的实施例中，内表面370可以是相对的平坦，并包括一可以是槽的偶联机构372。
端板组件364可包括一外表面374和一内表面376。在图30的实施例中，内表面376可以相对地平坦并可包括可以是一槽的偶联机构378。外表面368和374可相对地平行或可相对于彼此倾斜，以容纳特殊的脊柱前凸或前弯角。
核心部件366可包括一柔性层380和一附连到柔性层380的关节层382。关节层382可具有一凹陷表面384。柔性层380可包括呈突脊的一偶联机构386。核心部件366可具有一大致圆形的横截面(如从一垂直于纵向轴线44的平面观看)。替代的横截面形状也是理想的，在一单一的核心部件366中，横截面形状可以根据垂直平面的位置变化。
核心部件367可包括一柔性层388和一附连到柔性层388的关节层390。关节层390可具有一凸出表面392。柔性层388可包括呈突脊的一偶联机构394。核心部件367可具有一大致圆形的横截面(如从一垂直于纵向轴线44的平面观看)。替代的横截面形状也是理想的，在一单一的核心部件367中，横截面形状可以根据垂直平面的位置变化。
端板组件362、364可对应地用与端板组件22、24相同的或类似的材料形成，包括相同的或类似的特征或涂层，因此，不再作详细的描述。柔性层380、388可用与以上对于核心部件26所述的相同的柔性或弹性材料形成。关节层382、390可用与端板组件22、24相同或类似的材料形成。或者，关节层382、390可用与以上对于核心部件26所述的相同或类似的材料形成，仅在交连或离子注入方面有修改以提高耐磨性能。
如图30所示，假体360可通过机械地或粘结地将柔性层380附连到端板组件362的内表面370进行组装。偶联机构372可接合偶联机构386，提供机械的附连。附加地或替换地，可使用一粘结剂来附连柔性层380和内表面370。柔性层388可机械地和/或粘结地附连到端板组件364的内表面376。偶联机构378可接合偶联机构394，提供机械的附连。附加地或替换地，可使用一粘结剂来附连柔性层388和内表面376。关节层382的凹陷表面384可定位在凸出的关节表面392上。组装的部件可植入到由移去盘12而形成的空穴内的脊柱10内(图1)，以使外表面368接合椎骨体14的端板，而外表面374接合椎骨体16的端板。
在手术中，关节层382的凹陷表面384可与关节层390的凸出表面392形成关节连接。假体360可在平行于纵向轴线44的压缩载荷下弹性地变形以吸收冲击和提供阻尼作用。核心部件366和核心部件367之间的关节接触面，以及柔性层380的弹性可允许作弯曲延伸和侧向弯曲运动，或围绕纵向轴线44作轴向转动。端板组件362、364也可相对于彼此转动。
现参照图31-32，一椎间盘假体400可用作为图2的假体18。根据本发明的该实施例，椎间盘假体400包括端板组件402、404和一核心部件406。端板组件402可包括一外表面408和一内表面410。在图31的实施例中，内表面410可包括一相对地凹陷的部分，其可以是如镜面那样光滑。端板组件404可具有一外表面412和一内表面414。内表面414可包括一相对地凹陷的部分。可以是缓冲器的偶联机构416可从内表面410、414突出。
核心部件406可包括一柔性层418和附连到柔性层418的外关节层420、422。关节层420、422可包括可以是槽的偶联机构424。一个或多个系带426可在端板组件402和404之间延伸。
端板组件402、404可对应地用与端板组件22、24相同的或类似的材料形成，包括相同的或类似的特征或涂层，因此，不再作详细的描述。柔性层418可用与以上对于核心部件26所述的相同的柔性或弹性材料形成。关节层420、422可用与端板组件22、24相同或类似的材料形成。或者，关节层420、422可用与以上对于核心部件26所述的相同或类似的材料形成，仅在交连或离子注入方面有修改以提高耐磨性能。系带426可以是弹性的或非弹性的。例如，它们可以是由诸如钢丝、缆索、线、带、带子，或板那样的加强材料形成。它们可用以上对于端板组件22、24或核心部件26所述的任何材料形成(诸如UHMWPE)。在某些实施例中，系带426可以是编结的、针织的或纺织的。
如图31所示，假体400可通过将核心部件406定位在端板组件402、404的内表面410、414之间进行组装。缓冲器416可定位成沿关节层420、422的槽424移动。某些实施例可具有两个和四个缓冲器/槽之间的接触面。一个或多个系带426可在端板组件402、404之间延伸，以提供附加的稳定性和/或在经受弯曲/延伸、侧向弯曲或轴向转动力时对假体400提供附加的约束。如图31所示，系带426可在端板组件402、404之间延伸，而不通过核心部件406。组装的假体400可定位在椎骨14、16之间的脊柱10内。
再次参照图31-32，在手术中，缓冲器416可沿关节层420、422的槽424移动，允许围绕纵向轴线44作有限的转动。与缓冲器416的长度相比，该转动由槽424的长度限制。例如，几乎与槽424同长的缓冲器416将允许很小或没有转动。在某些实施例中，1和20度之间的转动是许可的。某些实施例可将转动限制到3和10度之间。系带426也可在弯曲/延伸、侧向弯曲和/或轴向转动运动中约束假体400。在组件的约束内，假体400可在平行于纵向轴线44的压缩载荷下弹性地变形以吸收冲击和提供阻尼作用。端板组件402、404和核心部件406之间的关节接触面以及柔性层418的弹性可允许弯曲延伸、侧向弯曲或围绕纵向轴线44的轴向转动运动。
现参照图33-34，一椎间盘假体430可用作为图2的假体18。根据本发明的该实施例，椎间盘假体430包括端板组件432、434和一核心部件436。端板组件432可包括一内表面438。在图33的实施例中，内表面438可包括一相对地凹陷的部分，其可以是如镜面那样光滑。端板组件434可具有一内表面440。内表面440可包括一相对地凹陷的部分。可以是缓冲器的偶联机构441可从内表面438、440突出。
核心部件436可包括一柔性层442和附连到柔性层442的外关节层444、446。关节层444、446可包括可以是槽的偶联机构447。一个或多个系带448可在关节层444、446之间延伸，沿对角方向通过柔性层442。附加地或替代地，一个或多个系带449可在关节层444、446之间延伸，相对地平行于轴线44通过柔性层442。
端板组件432、434可对应地用与端板组件22、24相同的或类似的材料形成，包括相同的或类似的特征或涂层，因此，不再作详细的描述。柔性层442可用与以上对于核心部件26所述的相同的柔性或弹性材料形成。关节层444、446可用与端板组件22、24相同或类似的材料形成。或者，关节层444、446可用与以上对于核心部件26所述的相同或类似的材料形成，仅在交连或离子注入方面有修改以提高耐磨性能。系带448、449可以是弹性的或非弹性的。例如，它们可以是由诸如钢丝、缆索、线、带、带子，或板那样的加强材料形成。它们可用以上对于端板组件22、24或核心部件26所述的任何材料形成(诸如UHMWPE)。在某些实施例中，系带448、449可以是编结的、针织的或纺织的。
如图33所示，假体430可通过将核心部件436定位在端板组件432、434的内表面438、440之间进行组装。缓冲器441可定位成沿关节层444、446的槽447移动。某些实施例可具有两个和四个缓冲器/槽之间的接触面。一个或多个系带448、449可在关节层444、446之间延伸，以提供附加的稳定性和/或在经受弯曲/延伸、侧向弯曲或轴向转动力时对假体430提供附加的约束。组装的假体430可定位在椎骨14、16之间的脊柱10内。
在手术中，缓冲器441可沿关节层444、446的槽447移动，允许围绕纵向轴线44作有限的转动。与缓冲器441的长度相比，该转动可由槽447的长度限制。例如，几乎与槽447同长的缓冲器441将允许很小或没有转动。在某些实施例中，1和20度之间的转动是许可的。某些实施例可将转动限制到3和10度之间。系带448、449也可在弯曲/延伸、侧向弯曲和/或轴向转动运动中约束假体430。例如，对角地布置的系带448可在槽447冲击缓冲器441时加强柔性层442以抵抗扭转剪切。系带448、449可单独地或彼此组合地使用。在组件的约束内，假体430可在平行于纵向轴线44的压缩载荷下弹性地变形以吸收冲击和提供阻尼作用。端板组件432、434和核心部件436之间的关节接触面以及柔性层442的弹性可允许弯曲延伸、侧向弯曲或围绕纵向轴线44的轴向转动运动。
现参照图35-36，一椎间盘假体450可用作为图2的假体18。椎间盘假体450可包括端板组件452、454和一核心部件456并可包括上述假体的任何结构。核心部件456可包括一柔性层458，它可包括一个或多个变态元件460。柔性层458可以由与以上对于核心部件26所述的相同的柔性或弹性材料形成。
如图35-36，假体450包括两个腰子形状的变态元件460(如从图36的俯视截面图中观看)。该假体450可以植入，以使变态元件460之一位于前面位置，而一个位于后面位置，以促进或限制延伸和/或弯曲运动。或者，假体450可转动和植入，以使变态元件460侧向地定位，促进或限制侧向弯曲。
如图37-38所示，一假体470可包括一具有一单一变态元件474的核心部件472。在此实施例中，单一变态元件474可位于核心部件472中心附近，致使核心部件的中心区域显现不同于核心部件圆周区域的刚度。单一变态元件474可形成为任何几何形，包括一球体或一椭球体。变态元件474可具有耐磨的圆形边缘。
如图39-40所示，一假体490可包括一具有一单一变态元件494的核心部件492。在此实施例中，变态元件494可以是核心部件492内的一环形区域。
如图41-42所示，一假体500可包括一具有散布在全部核心部件内的多个变态元件514的核心部件512。
变态元件460、474、494、514可以是材料和/或空穴，其控制、调整或修改硬度、刚度、柔度，或相邻柔性层的顺从性。变态元件460、474、494、514可以是任何尺寸、形状或材料，以允许核心部件456、472、492、512的刚度对应地变化。例如，核心部件456、472、492、512的某些区域可对应地设置有变态元件460、474、494、514，以在修改区域和非修改区域之间提供不同的刚度。可使用各种变态元件的结构来改变核心部件的刚度，以上所述只是几个实例。变态元件可以是在柔性层内的离散本体，或可具有一梯度的质量，其允许变态元件混合到柔性层内，例如，沿着一径向方向。
变态元件460、474、494和514可分别由不同于核心部件456、472、492、512的材料形成，包括以上对于端板组件22、24或核心部件26所述的任何材料。材料可以比柔性层的材料更刚或更柔。变态元件460、474、494和514可以是空隙，而在某些实施例中，一个或多个空隙可起作容纳治疗药的容器，诸如止痛剂、抗发炎物质、生长因子、抗生素、类固醇、块状药物，或各种药物的组合。生长因子可包括任何数量族的转化生长因子beta(TGF-beta)、骨形成素蛋白质(BMP)、重组体人类骨形成素蛋白质(rh BMP)、胰岛素状生长因子、血小板衍生的生长因子、纤维原细胞生长因子，或任何帮助促进周围组织的组织修理的其它生长因子。
尽管以上仅详细地描述了本发明几个示范的实施例，但本技术领域内的技术人员容易地认识到，在不脱离本发明新颖内容和优点的前提下，示范实施例中可作出许多修改。因此，所有如此的修改都欲包括在由附后权利要求书所定义的本发明的范围之内。在权利要求书中，装置加功能方式描述的条款意图涵盖本文所描述的作为执行所陈述功能的结构，不仅是结构的等价物，而且是等价的结构。

Claims (60)

1.一插入在两个椎骨端板之间的椎骨移植物，包括：
一用来接合第一椎骨端板的第一端板组件；
一用来接合第二椎骨端板的第二端板组件；以及
一插入在第一和第二端板组件之间的第一柔性核心部件，第一柔性核心部件包括一第一端部和一第二端部，
其中，第一端部偶联到第一端板组件以限制第一端部相对于第一端板组件的平移，其中，第二端部相对于第二端板组件可枢转。
2.如权利要求1所述的椎骨移植物，其特征在于，第二端部偶联到第二端板组件，以限制第二端部相对于第二端板组件的平移，其中，第一端部相对于第一端板组件可枢转。
3.如权利要求1所述的椎骨移植物，其特征在于，第一端板组件相对于第二端板组件沿横向于延伸通过第一和第二椎骨端板的纵向轴线的方向关节连接。
4.如权利要求1所述的椎骨移植物，其特征在于，第一柔性核心部件包括一第一耐磨关节表面，而第二端板包括一光滑的关节表面。
5.如权利要求4所述的椎骨移植物，其特征在于，第一耐磨关节表面呈凸出，而光滑的关节表面呈凹陷。
6.如权利要求4所述的椎骨移植物，其特征在于，第一耐磨关节表面呈凹陷，而光滑的关节表面呈凸出。
7.如权利要求4所述的椎骨移植物，其特征在于，第一耐磨关节表面和光滑的关节表面都是平坦的。
8.如权利要求4所述的椎骨移植物，其特征在于，第一耐磨关节表面包括一超高分子量的聚乙烯(UHMWPE)。
9.如权利要求4所述的椎骨移植物，其特征在于，第一耐磨关节表面包括钴铬合金。
10.如权利要求4所述的椎骨移植物，其特征在于，第一耐磨关节表面包括交连的UHMWPE。
11.如权利要求4所述的椎骨移植物，其特征在于，第一耐磨关节表面包括聚醚酮醚(PEEK)。
12.如权利要求4所述的椎骨移植物，其特征在于，第一耐磨关节表面包括用金属离子注入处理的聚亚安酯。
13.如权利要求1所述的椎骨移植物，其特征在于，第一柔性核心部件包括一第二耐磨关节表面，而第二端板包括一光滑的关节表面。
14.如权利要求1所述的椎骨移植物，其特征在于，第一柔性核心部件包括覆盖不到第一柔性核心部件的全部表面的第一和第二耐磨关节表面。
15.如权利要求1所述的椎骨移植物，其特征在于，第一柔性核心部件包括聚亚安酯。
16.如权利要求1所述的椎骨移植物，其特征在于，第一柔性核心部件包括硅树脂。
17.如权利要求1所述的椎骨移植物，其特征在于，第一柔性核心部件包括水凝胶。
18.如权利要求1所述的椎骨移植物，其特征在于，第一柔性核心部件包括硅树脂和聚亚安酯的共聚物。
19.如权利要求1所述的椎骨移植物，其特征在于，还包括一附连到第二端板组件的第二核心部件，第二核心部件包括一柔性材料。
20.如权利要求19所述的椎骨移植物，其特征在于，第二核心部件还包括一第二耐磨关节表面。
21.如权利要求1所述的椎骨移植物，其特征在于，第一端板组件包括一第一偶联机构，其中，第一核心部件用第一偶联机构偶联到第一端板组件。
22.如权利要求21所述的椎骨移植物，其特征在于，第一偶联机构是一槽，用来接合第一核心部件的互补的突脊。
23.如权利要求21所述的椎骨移植物，其特征在于，第一偶联机构是一第一缓冲器，用来接合形成在第一核心部件内的第一槽。
24.如权利要求23所述的椎骨移植物，其特征在于，第一缓冲器和第一槽限制枢转在1和20度转动之间。
25.如权利要求23所述的椎骨移植物，其特征在于，还包括至少一个延伸在第一端板组件和第二端板组件之间的系带，以限制椎骨移植物的运动。
26.如权利要求25所述的椎骨移植物，其特征在于，至少一个系带包括一纺织线。
27.如权利要求25所述的椎骨移植物，其特征在于，至少一个系带包括一钢丝。
28.如权利要求21所述的椎骨移植物，其特征在于，第二端板组件包括一第二偶联机构，其中，第一柔性核心部件用第二偶联机构偶联到第二端板组件。
29.如权利要求28所述的椎骨移植物，其特征在于，第二偶联机构是一第二缓冲器，其用来接合形成在第一柔性核心部件内的第二槽。
30.如权利要求1所述的椎骨移植物，其特征在于，还包括至少一个延伸在第一柔性核心部件的第一和第二端部之间的系带，以限制椎骨移植物的运动，其中，至少一个系带通过第一柔性核心部件。
31.如权利要求30所述的椎骨移植物，其特征在于，至少一个系带以倾斜于一延伸通过椎骨端板的纵向轴线的角度延伸。
32.如权利要求20所述的椎骨移植物，其特征在于，至少一个系带平行于一延伸通过椎骨端板的纵向轴线延伸。
33.如权利要求1所述的椎骨移植物，其特征在于，还包括至少一个嵌入在第一柔性核心部件内的变态元件，以修改第一柔性核心部件的柔度，其中，变态元件包括一不同于第一柔性核心部件的材料。
34.如权利要求33所述的椎骨移植物，其特征在于，至少一个变态元件是位于第一柔性核心部件内的一对腰子形的变态元件。
35.如权利要求33所述的椎骨移植物，其特征在于，至少一个变态元件形成一位于第一柔性核心部件内的环。
36.如权利要求33所述的椎骨移植物，其特征在于，至少一个变态元件是对中在第一柔性核心部件内的一单一本体。
37.如权利要求33所述的椎骨移植物，其特征在于，至少一个变态元件是随机地散布在整个第一柔性核心部件内的多个变态元件。
38.如权利要求33所述的椎骨移植物，其特征在于，至少一个变态元件包括一金属。
39.如权利要求33所述的椎骨移植物，其特征在于，至少一个变态元件包括一弹性体。
40.如权利要求33所述的椎骨移植物，其特征在于，至少一个变态元件是一空穴。
41.如权利要求40所述的椎骨移植物，其特征在于，空穴用治疗药物填充。
42.如权利要求1所述的椎骨移植物，其特征在于，第一端板组件具有一矩形形状。
43.如权利要求1所述的椎骨移植物，其特征在于，第一端板组件具有一腰子形状
44.如权利要求1所述的椎骨移植物，其特征在于，第一端板组件具有一椭圆形状
45.如权利要求1所述的椎骨移植物，其特征在于，第一端板组件包括一第一外表面，而第二端板组件包括一第二外表面，其中，第一和第二外表面相对于彼此倾斜。
46.如权利要求45所述的椎骨移植物，其特征在于，第一端板组件呈楔形。
47.如权利要求45所述的椎骨移植物，其特征在于，第一柔性核心部件呈楔形。
48.如权利要求1所述的椎骨移植物，其特征在于，第一端板组件包括一第一外表面，其中，至少一个固定特征从第一外表面突出。
49.如权利要求48所述的椎骨移植物，其特征在于，至少一个固定特征是一组长钉。
50.如权利要求48所述的椎骨移植物，其特征在于，至少一个固定特征是一个或多个变粗糙的龙骨。
51.如权利要求48所述的椎骨移植物，其特征在于，至少一个固定特征是一金刚石切割表面。
52.一插入在两个椎骨端板之间的椎骨移植物，包括：
一用来接合第一椎骨端板的第一端板组件；
一用来接合第二椎骨端板的第二端板组件；以及
一插入在第一和第二端板组件之间的第一柔性核心部件，第一柔性核心部件包括一外表面，
其中，外表面包括一关节表面，该关节表面覆盖不到全部的外表面，以及
其中，第一端板组件包括一形状与第一柔性核心部件的轮廓匹配的偶联机构。
53.如权利要求53所述的椎骨移植物，其特征在于，偶联机构是一凸出的弧形部分，形状与第一柔性核心部件内的凹陷匹配。
54.如权利要求53所述的椎骨移植物，其特征在于，偶联机构是一环形突出部分，形状与第一柔性核心部件内的环形凹陷匹配。
55.如权利要求53所述的椎骨移植物，其特征在于，第一柔性核心部件是花托形状，而偶联机构是一凸出弧形的突出部。
56.如权利要求53所述的椎骨移植物，其特征在于，偶联机构是一组同心的燕尾槽。
57.一插入在两个椎骨端板之间的椎骨移植物，该椎骨移植物包括：
一第一端板组件，包括一第一椎骨端板接触表面和一第一内表面；
一第二端板组件，包括一第二椎骨端板接触表面和一第二内表面；
一柔性核心部件，插入在第一和第二内表面之间，柔性核心部件包括一第一端部和一第二端部，
其中，第一端部包括一用来偶联到第一内表面的偶联机构，以防止第一端部相对于第一端板组件平移，以及
其中，第二端部相对于第二端板组件可枢转。
58.如权利要求57所述的椎骨移植物，其特征在于，第一端部附连到第一端板组件，以防止第一端部和第一端板组件之间的转动。
59.如权利要求57所述的椎骨移植物，其特征在于，第一端部硬度大于柔性核心部件的柔性部分的硬度。
60.如权利要求57所述的椎骨移植物，其特征在于，柔性核心部件的关节部分硬度大于第一端部的硬度。
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