DE19710392C1 - Slipped disc implant comprises an extensible, hinged or wound body - Google Patents

Abstract

A slipped disc implant, for filling and supporting the intervertebral space, is in the form of an extensible, hinged or wound body which reproduces the slipped disc shape in the closed or wound-up condition.

Description

The invention relates to an intervertebral disc implant, in particular for the lumbar and thoracic vertebrae, according to the preamble of Claim 1.

As is known, the intervertebral disc in the spine takes over central functions. It serves as a damper as well Spacers as well as a joint between the vertebral bodies. Operations for damage to the lumbar and / or intervertebral discs The position of the thoracic spine in the ventral area, d. H. on the front of the spine, difficult. The ven Central access is avoided if possible because it is operative is very complex and particularly difficult. He will in particular which complicates and makes it difficult due to the position of the internal organs mostly the additional involvement of an abdominal surgeon is required such.

In the dorsal, i.e. H. from the back leave the dorsal structures of the spine (vertebral arches, small we joint joints and spinous processes) and the nervous system at one took up little scope for operational measures to. That is why it is a common method of operation - even when it is off clearing of the entire intervertebral disc - the dorsal fixation of the Vertebrae with an internal fastener, a so-called "internal fixator", d. H. a rod or plate system, wel ches about pedicle screws at the transitions between vertebrae  arch and vertebral body, the pedicles, is attached as it is known for example from DE 42 43 951 A1. Doing so the function of maintaining a distance from the "internal fixator" taken over, while the damping and joint function of the Intervertebral disc is completely eliminated.

This approach is problematic because of the support far from the point of departure. As a result, be pregnant forces on the system "pedicle - pedicle screw - Fixator rods ", which lead to tearing and breaking of screws being able to lead. Because of these disadvantages and risks for Pa Instead, the principle of treating Schä preferred if possible directly at the place of origin.

So it is known, so-called "titanium cages" for immediate Support the vertebral body. The "Titan Cages" are cylindrical or cuboid cages that are dorsally separated by an egg ne opening of approx. 1 cm diameter lengthways in the intermediate wire be introduced. Then these cages with autologists, d. H. body's own bone chips filled up, whereby the vertebral bodies grow together should. For the extraction of bone chips, which are usually dated Removed the iliac crest is a secondary procedure beforehand required.

However, problems are also associated with this known method the. The cage usually only covers a small one, namely that soft, cancellous part of the vertebral cover plates. Thereby can break into one of the adjacent vertebrae follow, which does not result in the desired support poses. Another disadvantage is that the secondary intervention an additional operational effort with the ent speaking impairments and side effects.

A vertebral body implant is known from DE 43 15 757 C1, the one that can be used between adjacent vertebral bodies Spacer with upper and lower cover plate and one spring-elastic arranged between the two cover plates  Intermediate element exists. On the outside of the cover plates vertebral anchoring elements are provided. The two rule element has an approximately U-, S- or W-shaped curve Plate made of biocompatible material. To what extent this Implant has proven itself in practice is not known. Since that But implant should always replace an entire intervertebral disc and in one piece in the intervertebral space must, a relatively wide access opening on the elaborate ventral access to be exposed.

EP 0 453 393 A1 describes an intervertebral prosthesis wrote that made of an elastic, liquid-tight Hollow body from an elongated, flexible chamber be stands with an incompressible, flowable medium is fillable. At one end the chamber has an ach se rotatable valve on which the chamber can be wound rend the other end of the chamber in a compact band continues. The implant is initially elongated from dorsal through a tube into the intervertebral disc space, then the cam with the help of a drive belt always wound on the valve, the free end of the tape fixed on itself by welding or sewing and the Strap removed. Finally the chamber with the filling medium um filled. To wind up and fill the implant in the Creating intervertebral space is quite a com plicated, sophisticated technology that is very necessary agile and consequently expensive to manufacture and difficult rig is in use.

The invention is based on the object State of the art in construction, handha Exercise and mode of operation significantly improved intervertebral discs to develop a plantation that is very small NEN access are introduced into the intervertebral space and a secure support of the adjacent vertebrae Maintaining the original vertebral body distance  that can guarantee. Furthermore, the intervertebral disc implant be constructed so that it is at least one Part of the damping and joint functions of an intervertebral disc can take over.

According to the invention, this object is achieved by means of a band shit benimplantat according to the characterizing features of the claim 1. Advantageous embodiments of the tape according to the invention disc implants are in the subclaims 2 to 38 cha characterizes.

Accordingly, this is particularly noticeable for the loins vertebral and / or thoracic vertebrae suitable and the Zwi vertebral space to a large extent filling and supporting intervertebral disc implant in that it has a stretchable, d. H. can be opened and closed or unrolled and rolled up formable body that is solid and designed so that he egg in the closed or rolled up state ner intervertebral disc or at least part of an intervertebral disc reproduces.

So that the intervertebral disc implant according to the invention by as small as possible opening in the intervertebral space can be inserted, it is necessary that the implant stretched in a stretch before insertion into the intervertebral space th form is present and only passes in the intervertebral space agreed, the intervertebral space completely or at least to one takes on an essential part of the filling form.

The intervertebral disc implant according to the invention is in a before preferred embodiment of several contiguous, under massive segments movably connected to one another puts. These are designed so that through their entirety the shape of an intervertebral disc or at least part of one Intervertebral disc is reproducible. The number of segments from de NEN the implant can be very different and at for example between 2 and 20. Since the properties of the Intervertebral disc implant also affected by the number of segments  it is recommended that the number of segments is not too big to choose. In a particularly preferred embodiment shape is the intervertebral disc implant of four composed of up to eight segments.

So that the entirety of the segments at least approximates the Shape and dimension of the intervertebral disc to be replaced or one Can accept part of the intervertebral disc, the individual seg elements have a correspondingly adapted partial shape. Preferential each of the segments has the shape of an arc, circular or elliptical ring sector, since segments with these Forms the easiest and without difficulties in the interwire Belraum enter the desired or predetermined arrangement.

For reasons of stability, the segments must be massive. From that apart from that, the construction of the segments can be very diverse be active. However, simple forms become economical for reasons of complexity, preference is given to segments in block form are particularly preferred. In a another, also particularly preferred embodiment each individual segment a base plate and a cover plate on, which are so stable that after installation in the intervertebral space the tensile and compressive loads with Si security have grown. Between the base and cover plate intermediate elements are arranged, preferably at least partially made of elastic material.

In another preferred embodiment of the invention the base and top surfaces of the segments or the surface Chen the base and cover plates of the segments with elevations or projections, for example with spike-like extensions, provided with a firm anchorage of the implant with the adjacent vertebrae is effected.

So that the band composed of a number of segments disc implant before insertion into an intervertebral disc the space can be opened or stretched out NEN segments are movably connected to each other, namely  Adjacent segments preferably over joints and / or over one or more pull wires connected together.

The joints can be in various ways known per se be performed, provided that the segments they connect with each other flexibly, open as far as possible, that the maximum opening angle is sufficient to cover the whole of the lined up segments into an approximately extended one Bring able so that the segments z. B. by a straight line Guide tube can be easily passed through. In a preferred embodiment, the joints are between the individual segments as mechanical hinges det, through which the segments are in approximately straight rows foldable and in closed or open predetermined Ge are collapsible.

In a further, likewise preferred embodiment the joints between the individual segments as elastic Material joints or band joints with elastic deformable speed formed, the opening angle in turn so large is chosen that the segments in an approximately straight row foldable and in closed or open predetermined Ge are collapsible.

The shape and number of segments is advantageously so chooses that all of the segments in collapsed form preferably all or part of an arc, circle or el has a lip-shaped shape, through which the shape of the replacing intervertebral disc in sufficient approximation can be detected.

The execution of the joints between the individual segments as elastic material joints or ligament joints with elasti shear deformability leads to a one-piece in the limit case Implant in which the segments and joints in a single massive moldings are united. This, also preferred te embodiment of the invention is characterized in that the equally movable solid molded body from one  single band-shaped, curved segment be stands, its dimensions to the dimensions of the he disc or part of this disc are voted.

In a particularly preferred embodiment, this form body very elongated, spirally rollable and with provide a stiffening profile. The profile of the Shaped body have any shape, if only the purpose of one sufficient stiffening of the relatively long molded body is enough. Preferably, the profile of the spiral wound shaped body designed so that two adjacent Parts lie close together and / or form-fit are connectable, whereby the intervertebral disc implant in its final shape has the necessary strength to important functions of support and spacing in the Ensure intervertebral space safely over very long times to be able to.

The profile of the spiral is particularly preferred Celts shaped body designed so that the by the shaped body per formed base and / or top surface surveys or Projections, e.g. B. thorn-like extensions, whereby a facilitated firm anchoring of the implant in the adj beard vertebrae is reached.

Both the one-piece, arc-shaped body for the intervertebral disc implant as well as the several segments from which the implant according to the invention can be constructed, preferably consist entirely or partially made of stainless steel, titanium or titanium alloys, esp preferably at least partially made of special alloys Shape memory and / or pseudo-elasticity, for the different ne alloys are suitable, of which a special alloy 54 to 56% by weight of nickel and 46 to 44% by weight of titanium in particular is preferably used.  

An additional improvement in practical handling of the intervertebral disc implant according to the invention during insertion of the implant in the intervertebral space and in the manufacture development and fixation of the final shape of the implant in the interim Whirling space is created by the application of one or more Tension wires reached, both at the one-piece, from one single rollable molded body existing intervertebral discs in plantat as well as in the multi-piece version by a Number of segments connected movably to one another can be. Preferably the one or more trains wires housed laterally in the rollable molded body and in the segments in channels, particularly in the Base and / or cover plates are housed, or in Aus savings or grooves of the intermediate elements of the segments arranges.

So that when inserting the intervertebral disc implant in the Intervertebral space and in the formation of the final shape of the implant in the intervertebral space using the pull wires exerted tensile forces on the molded body or the segments can act is in a preferred embodiment of the Er Invention provided that the one or more pull wires attachable to the front end of the first segment are. In another, also preferred embodiment are the free leading ends of the one or more Pull wires after exiting the foremost (first) segment the free rear ends of the one or more pull wires traceable. This creates the possibility that Intervertebral disc implant during insertion vertebral space and in the formation of the final closed Shape by exerting tensile force at one end as needed or controlled and regulated at both ends of the pull wires rend to lead.

The joints between the segments and the pull wires can best from any sufficiently solid, body-compatible material  hen, e.g. B. from stainless steels, titanium or titanium alloy or body-friendly plastics such as polyethylene len or polyurethane. The joints preferably exist and / or all or part of the pull wires made of a special alloy with shape memory and / or pseudo-elasticity, be especially preferred from a special alloy from 54 to 56 % By weight nickel and 46 to 44% by weight titanium.

So that the multiple segments of an intervertebral disc implant after Formation of the final shape in the intervertebral space possible as precise and firm as possible in the given arrangement ben, it is also preferably provided that the end faces two adjacent segments each with a corresponding prefix jumps and depressions are positively connectable.

Best for inserting one of one or more segments intervertebral disc implant of the type described above into an intervertebral space from which the damaged one had previously been The intervertebral disc has been removed in whole or in part disc implant in the opened or extended form one end of a guide sleeve (trocar) is inserted and through the guide sleeve over the other, beveled End of the guide sleeve, which is possible on the intervertebral space is positioned as close as possible by tensile and / or compressive forces be transported into the intervertebral space. It gets in there brought a predetermined closed or open shape and then completely or partially fills the intervertebral space. There at is preferably that of several connected be movable shaped bodies in the form of segments existing Intervertebral disc implant in its entirety in the intermediate Space arch, circular or elliptical and all from one single, rollable molded body existing intervertebral discs in implant in the intervertebral space in an arch or spiral shape orderly.

The guide sleeve for inserting the intervertebral disc implant into the implant structure can open the intervertebral space  record folded or stretched state. So that the one guide and arrange the intervertebral disc implant quickly and easily can be done without training, is in a preferred embodiment provided that with the help of one or more pull wires, those in the molded body or the multiple segments of the band disc implant are arranged, a tensile force on the Shaped body or the segments through which the Intervertebral disc implant in the desired shape or arrangement brought.

The pull wires are used for the controlled insertion of the tape disc implant in the intervertebral space, but also for Securing the final shape of the implant. To this Purpose are the pull wires preferably after reaching the ge desired shape or arrangement of the intervertebral disc implant and permanently after removing the guide sleeve at its ends fixed. In another preferred embodiment of the Erfin the free front ends of the pull wires after the Emerge from the front of the intervertebral disc implant be returned through the guide sleeve and it will wee rend or after insertion of the intervertebral disc implant in the intervertebral space on the free front ends and / or the free rear ends of the pull wires have a pulling force exercises through which the intervertebral disc implant in the desired Ge stalt or arrangement is brought.

So that the shape or arrangement formed in the intervertebral space of the intervertebral disc implant even under stress is preserved for a long time, preferably the front ones and / or rear free wire ends after reaching the ge desired shape or arrangement of the intervertebral disc implant and permanently fixed after removing the guide sleeve.

In a particularly preferred embodiment of the invention provided that a pseudo-elastic shape memory alloy, which previously imprinted the desired shape or arrangement Was used as an implant material for the whole or part  Intervertebral disc implant is used. It is suitable for this especially the above-mentioned special alloy from 54 to 56 % By weight nickel and 46 to 44% by weight titanium.

The dimensions of the intervertebral disc implant according to the invention can easily be used for a dorsal or minimal vasive ventral implantation possible opening of the interwir belraumes and on the original vertebral body distance be true. Another advantage of the invention is in that the multiple segments or the one arcuate ge curved shaped body of the intervertebral disc implant designed in this way can be that they next to a safe support also the damping and joint functions of an intact Take over the intervertebral disc.

Anchoring the intervertebral disc implant with the adjacent the vertebral bodies are covered by a corresponding surface design of the base and top surfaces by surveys or Protrusions guaranteed. An additional reduction instruction mentarium may become necessary to the concerned us Furniture body for the purpose of implantation at the necessary distance adjust the ease of insertion of the implant enables. Another advantage of the invention is that as a rule under favorable conditions on one "internal fixator" can be dispensed with.

Below are preferred embodiments of the invention explained in more detail with reference to the accompanying drawings. Show it:

Fig. 1 is an overall perspective view of an inventively designed, consisting of several solid segments intervertebral disc implant between two We belkörpern;

Figure 2 is a perspective view of two adjacent segments in the opened position.

Fig. 3 is a perspective view of the two segments shown in Figure 2 when folded position.

Fig. 4 is a perspective view of a segment in another massive resilient embodiment;

Figure 5 is a perspective view of a segment in a solid block-shaped design.

Figure 6 is an overall perspective view of the introduction of an intervertebral disc consisting of several segments via a guide tube into the intervertebral space;

Fig. 7 is a perspective view of an embodiment of the one-piece, spirally wound intervertebral disc benimplantats;

FIG. 8 shows a cross section through the spirally wound intervertebral disk implant shown in FIG. 7;

Fig. 9 is a schematic perspective view of another embodiment of the one-piece, spirally wound intervertebral disc implant introduced via a feed tube.

In Fig. 1 a filling an intervertebral space, consisting of eight segments 2 , 3 , 4 .... a special embodiment be existing inventive intervertebral disc implant 1 is shown in its final position and shape between two vertebral bodies 20 delimiting the intervertebral space. The implant 1 is so matched to the dimensions of the adjacent vertebral body 20 that it completely fills and supports the intervertebral space, with the outer edge of the segments 2 , 3 , 4 .... resting on the cortical edges 21 of the vertebral body 20 .

In Fig. 2, two segments 2 and 3 are shown as part of an intervertebral disc implant 1 consisting of a number of mutually movably connected segments in the unfolded position. Each of the segments 2 and 3 is designed in the form of a circular ring sector and consists of a base plate 22 , a cover plate 23 and intermediate elements 8 arranged between the base and cover plate, which at least partially consist of elastic material. The Zwischenele elements 8 have in Fig. 2 a W-shaped shape, through which they give the segments 2 , 3 a certain spring elasticity under load.

In the embodiment shown in FIG. 2, the segments 2 , 3 are connected to one another in a movable manner via joints 5 and via pull wires 13 . The joints 5 can, as shown in Fig. 2 Darge, opened so far that the segments 2 , 3 can be opened in an approximately straight row. When the joints 5 are closed, the segments 2 , 3 , 4 ... form a circular intervertebral disk implant 1 in their entirety, as is shown schematically in FIG. 6.

The one or more pull wires 13, 13.1 can, as in FIG. 2 can be removed, to be in channels 12 .... passed through the segments 2, 3, 4, the channels 12 advantageously in the base and / or cover plates 22 , 23 are housed, or in recesses or grooves 19 , which are formed by W, S, M or U-shaped intermediate elements 8 , 9 , to be arranged. In Fig. 2, for the sake of simplicity, both two pull wires 13 guided in channels 12 and a pull wire 13.1 lying in recesses or grooves 19 are shown. In practice, one can restrict one of these embodiments with one or more pull wires 13 , 13.1 , which alone, possibly in conjunction with the joints 5 , already has the required mobility of the individual segments 2 , 3 , 4 .... guaranteed and when desired closing or collapsing the individual segments 2 , 3 , 4 .... in the intervertebral space exerts a sufficient tensile force on these segments, by means of which they are brought into a position which corresponds to the final shape of the intervertebral disc implant 1 in corresponds to the intervertebral space.

The pull wires are preferably on the front end face 24 of the first segment 14 located at the top of the plurality of segments 2 , 3 , 4 .... (see FIG. 6) by z. B. plombenar term closures attached.

So that a secure anchoring of the implant 1 on the neigh disclosed surfaces of the vertebral body 20 is promoted, the surfaces of the base and cover plates 22 , 23 of the segments 2 , 3 , 4 .... are provided with elevations or projections 6 , of which in Fig. 2 only those can be seen on the cover plates 23 .

As already mentioned above, the segments 2 , 3 , 4 .... can be designed differently, wherein in Fig. 2 in a preferred embodiment two segments 2 , 3 with spring elastic we kenden, cross-sectionally W-shaped intermediate elements 8 shown are. In Fig. 3 two such segments 2 , 3 are shown in the closed state.

In FIG. 4 is another, M-shaped, spring-elastically acting embodiment of the intermediate elements 9, which are also shown in the closed state of two segments 2, 3 as a part shown a number of segments 2, 3, 4 .....

The individual segments 2 , 3 , 4 .... can also be in a massive block-shaped embodiment, as shown in FIG. 5, before. The individual segment 2 shown in FIG. 5 has the shape of an arcuate ring sector, with a Grundober surface 22 (which is hidden in Fig. 5) and a Deckoberflä surface 23 , on which elevations or projections 6 are arranged at intervals (of which only those are visible on the top surface 23 ), which better anchor the implant 1 with the serve adjacent vertebral bodies 20 . The pull wires 13 enter the segment 2 on the rear end 25 , are guided through the segment 2 via the channels 12 and emerge from the segment 2 on the front end 24 . With the help of the joints 5 , of which only that on the front end face 24 is visible in FIG. 5, the segment 2 is movably connected to the adjacent segments, not shown here, which are designed in the same way.

The band disc implant 1 consisting of a number of segments 2 , 3 , 4 ... is, as shown schematically in FIG. 6, inserted in an unfolded form at one end of a guide sleeve 10 and through the guide sleeve 10 through the other through Bevel adapted to the spatial conditions at the edge of the intervertebral space end 11 of the guide sleeve 10 to the intervertebral space. By tensile and / or compressive forces with the help of the foremost (first) segment 14 by means of fastenings, for. B. Seals, attached pull wires 13 are transferred to the segments, the intervertebral disc is implanted 1 over the surface of the vertebral body located under the intervertebral body 20 in the intervertebral space, where it is in a predetermined closed or open shape, for. B. a complete or incomplete circular shape, and thereby completely or partially fills the intervertebral space. In Fig. 6, the stage is Darge, in which the introduction of the segments in the intervertebral space is not yet completely finished. While the first segments are already merging to form the predetermined final ring shape, the slanted end 11 of the guide sleeve 10 still enters the last segments in the unfolded shape into the intervertebral space. The segments are movably connected by the joints 5 in the horizontal plane and are brought into their desired position within the intervertebral space by the pull wires 13 . For reasons of better manageability, the free ends 16 of the pull wires 13 , after they have emerged from the front end face 24 of the first segment 14 , are returned to the outside through the guide sleeve 10 , so that they, possibly together with the rear ends 17 of the Tension wires 13 , for guiding the segments 2 , 3 , 4 .... and determining their final shape or arrangement in the intervertebral space can be used.

After have been all segments 2, 3, 4 .... introduced into the intervertebral space, and the final shape or configuration of the disk implant 1 is reached, the guide sleeve 10 is removed and the final shape or an arrangement, the implant 1 through firm fixing of Pull wires 13 at their free ends 16 , 17 , e.g. B. secured by knotting or twisting these ends.

Additional stabilization and securing of the benimplant 1 in its final shape or arrangement can be achieved in that the end faces 24 , 25 of two adjacent segments 2 , 3 , 4 .... by means of corresponding projections and depressions (not shown in the figures) with one another in a form-fitting manner are connectable.

Another, one-piece design of the intervertebral disc implant 1 according to the invention is shown in FIGS . 7 and 8 Darge. The implant 1 here consists of a ver stiffening profile, band-shaped, rollable form body 30 , the final shape of the implant 1 is shown in spiral form in FIGS . 7 and 8, which the implant 1 after insertion into the intervertebral space having. The profile of the shaped body 30 is selected so that two neighboring parts of the spirally wound shaped body 30 lie close together and are positively connected to one another, as can be seen in particular from the cross-sectional view of FIG. 8. Further, Figs. 7 and 8 show the formed by the spirally wound shaped body 30 base surface 32 and cover surface 33, which have for improving the interaction with the adjacent vertebral bodies elevations or projections 31.

The band-shaped, one-piece shaped body 30 is introduced into the intervertebral space in the same way as indicated above. The process is shown schematically in FIG. 9 with the vertebral bodies omitted. The intervertebral disc implant 1 consisting of the shaped body 30 is inserted into the guide sleeve 10 in an elongated form and introduced through the guide sleeve 10 through the beveled end 11 of the guide sleeve 10 into the intervertebral space, where it is to the extent that the shaped body 30 through the 's intervertebral space penetrating the guide sleeve 10 in the interim, spirally rolled up, as shown in Fig. 9. In a similar manner, as described for the intervertebral disk implant consisting of segments, pulling wires 13, not shown, can be accommodated in the shaped body in FIGS. 7 to 9, which during and after the insertion of the implant 1 into the intervertebral space by pulling and / or compressive forces to bring the intervertebral disc implant into the desired shape and position. A further possibility arises from the fact that the molded body 30 and / or the pull wires 13 are all or part of a special alloy with shape memory and / or pseudo-elasticity, which bring the intervertebral disc implant into the predetermined spiral shape by slight heating.

Claims (38)

1. Intervertebral disc implant, in particular for the lumbar and / or thoracic vertebrae area, which fills and supports the intervertebral space to a substantial extent, characterized in that it forms a stretchable, foldable and foldable or rollable and rollable molded body that is solid and such is designed such that it simulates the shape of an intervertebral disc or at least part of an intervertebral disc in the closed or rolled-up state. 2. Intervertebral disc implant according to claim 1, characterized in that the shaped body consists of a number of individual, mutually movably connected segments ( 2 , 3 , 4 ...), which are designed so that the shape of an intervertebral disc or at least part of an intervertebral disc can be reproduced. 3. Intervertebral disc implant according to claim 2, characterized in that it consists of four to eight segments ( 2 , 3 , 4 , ...) together. 4. Intervertebral disc implant according to claim 2 or 3, characterized in that each of the segments ( 2 , 3 , 4 ...) has the shape of an arcuate, circular or elliptical ring sector. 5. intervertebral disc implant according to one of claims 2 to 4, characterized in that the segments ( 2 , 3 , 4 ...) are designed blockför mig. 6. Intervertebral disc implant according to one of claims 2 to 4, characterized in that each individual segment ( 2 , 3 , 4 ...) has a base plate ( 22 ) and a cover plate ( 23 ) with intermediate arranged between the base and cover plate elements ( 8 , 9 ). 7. Intervertebral disc implant according to claim 6, characterized in that the intermediate elements ( 8 , 9 ) consist at least partially of elastic material. 8. Intervertebral disc implant according to one of claims 2 to 7, characterized in that the base and cover surfaces of the segments ( 2 , 3 , 4 ...) or the surfaces of the base and cover plates ( 22 , 23 ) of the segments ( 2nd , 3 , 4 ...) are provided with elevations or projections ( 6 ). 9. Intervertebral disc implant according to one of claims 2 to 8, characterized in that the segments ( 2 , 3 , 4 ...) consist entirely or partially of stainless steel, titanium or titanium alloys. 10. Intervertebral disc implant according to one of claims 2 to 8, characterized in that the segments ( 2 , 3 , 4 ...) at least partially consist of special alloys with shape memory and / or pseudo-elasticity. 11. Intervertebral disc implant according to claim 10, characterized records that the special alloy from 54 to 56 wt .-% Nic kel and 46 to 44 wt .-% titanium is composed. 12. Intervertebral disc implant according to one of claims 2 to 11, characterized in that adjacent segments ( 2 , 3 ) via joints ( 5 ) and / or via one or more pull wires ( 13 ) are interconnected. 13. Intervertebral disc implant according to claim 12, characterized in that the joints ( 5 ) and / or the pull wires ( 13 ) consist entirely or partially of a special alloy with shape memory and / or pseudo-elasticity. 14. Intervertebral disc implant according to claim 13, characterized records that the special alloy from 54 to 56 wt .-% Nic kel and 46 to 44 wt .-% titanium is composed. 15. Intervertebral disc implant according to one of claims 2 to 14, characterized in that the joints ( 5 ) between the individual segments ( 2 , 3 , 4 ...) are designed as mechanical hinges through which the segments ( 2 , 3 , 4 ...) can be opened in an approximately straight row and can be closed in a closed or open, predetermined shape. 16. Intervertebral disc implant according to one of claims 2 to 14, characterized in that the joints ( 5 ) between the individual segments ( 2 , 3 , 4 ...) as elastic material joints or intervertebral joints with elastic deformability are formed, by which Segments ( 2 , 3 , 4 ...) can be opened in an approximately straight row and can be closed in a closed or open predetermined shape. 17. Intervertebral disk implant according to one of claims 15 or 16, characterized in that the entirety of the segments ( 2 , 3 , 4 ...) has a curved, circular or elliptical shape in whole or in part in the closed form. 18. Intervertebral disc implant according to one of claims 2 to 17, characterized in that the one or more train wires ( 13 ) in channels ( 12 ) in the segments ( 2 , 3 , 4 ...), in particular in the basic and / or cover plates ( 22 , 23 ) or in recesses or grooves ( 19 ) of the intermediate elements ( 8 , 9 ) of the segments ( 2 , 3 , 4 ...). 19. Intervertebral disc implant according to one of claims 12 or 18, characterized in that the one or more train wires ( 13 ) on the front end face ( 24 ) of the first segment ( 14 ) can be fastened. 20. Intervertebral disc implant according to one of claims 12 or 18, characterized in that the free front ends ( 16 ) of the one or more pull wires ( 13 ) after exiting from the first segment ( 14 ) to the free rear ends ( 17 ) of one or the multiple pull wires ( 13 ) are traceable. 21. Intervertebral disc implant according to one of claims 2 to 20, characterized in that the end faces ( 24 , 25 ) each of two adjacent segments ( 2 , 3 , 4 ...) can be positively connected by corresponding projections and depressions. 22 intervertebral disc implant according to claim 1, characterized in that the movable in the same way massive Formkör by ( 30 ) consists of a single band-shaped, arcuate ge curved segment, its dimensions being matched to the dimensions of the intervertebral disc or part of this intervertebral disc are. 23. Intervertebral disc implant according to claim 22, characterized in that the shaped body ( 30 ) is designed spirally and / or is provided with a stiffening profile. 24. Intervertebral disc implant according to claim 23, characterized in that the profile of the molded body ( 30 ) is designed so that two adjacent parts of the spirally wound molded body ( 30 ) abut one another and / or can be positively connected to one another. 25. Intervertebral disc implant according to one of claims 23 or 24, characterized in that the profile of the shaped body ( 30 ) is designed such that the base surface ( 32 ) and / or top surface ( 33 ) formed by the spirally wound up molded body ( 30 ) or has projections ( 31 ). 26. Intervertebral disc implant according to one of claims 22 to 25, characterized in that the shaped body ( 30 ) with one or more, at the front end of the shaped body ( 30 ) BEFE stigbare pull wires ( 13 ) is provided. 27. Intervertebral disc implant according to one of claims 22 to 26, characterized in that the free front ends ( 16 ) of the one or more pull wires ( 13 ) after emerging from the front end of the molded body ( 30 ) to the free rear ends ( 17 ) of the one or more pull wires ( 13 ) are traceable. 28. Intervertebral disc implant according to one of claims 22 to 27, characterized in that the shaped body ( 30 ) is made entirely or partly of stainless steel, titanium or titanium alloys. 29 intervertebral disc implant according to one of claims 22 to 28, characterized in that the shaped body ( 30 ) and / or the pull wires ( 13 ) are wholly or partly made of a special alloy with shape memory and / or pseudo-elasticity. 30. Intervertebral disc implant according to claim 29, characterized records that the special alloy from 54 to 56 wt .-% Nic kel and 46 to 44 wt .-% titanium is composed. 31. Intervertebral implant according to one or more of the Ansprü che 1 to 30, characterized in that where there sleeve one end of a guide in up folding ter or extended form introduced (10) and inclined by the guide sleeve (10) out through over the other, End ( 11 ) of the guide sleeve ( 10 ), which is positioned on the intervertebral space, can be conveyed by tensile and / or compressive forces into the intervertebral space, where it can be brought into a predetermined closed or open shape and thereby the intervertebral space entirely or partially filled out. 32. Intervertebral disc implant according to claim 31, characterized in that the intervertebral disc implant ( 1 ) consisting of several contiguous movable segments ( 2 , 3 , 4 ...) can be arranged in its entirety in the intervertebral space in an arcuate, circular or elliptical manner . 33. Intervertebral disc implant according to claim 31, characterized in that the existing intervertebral disc implant ( 1 ) consisting of a single segment ( 30 ) can be arranged in the intervertebral space in an arcuate or spiral manner. 34. Intervertebral disc implant according to one of claims 31 to 33, characterized in that with the help of one or more ren pulling wires ( 13 ) which in one ( 30 ) or more segments ( 2 , 3 , 4 ...) of the intervertebral disc implant ( 1 ) are arranged, a tensile force can be exerted on the molded body ( 30 ) or the segments ( 2 , 3 , 4 ...) through which the intervertebral disc implant ( 1 ) is brought into the desired shape or arrangement. 35. Intervertebral disc implant according to claim 34, characterized in that the pull wires ( 13 ) after reaching the desired shape or arrangement of the intervertebral disc implant ( 1 ) and after removing the guide sleeve ( 10 ) at their ends ( 16 , 17 ) are permanently fixed can. 36. Intervertebral disc implant according to one of claims 34 or 35, characterized in that the free front ends ( 16 ) of the puller wires ( 13 ) after exiting from the front part of the intervertebral disc implant ( 1 ) can be returned through the guide sleeve ( 10 ), and that during or after the insertion of the intervertebral disc implant ( 1 ) into the intervertebral space on the free front ends ( 16 ) and / or the free rear ends ( 17 ) of the tension wires ( 13 ), a tensile force can be exerted by which the intervertebral disc implant ( 1 ) is brought into the desired shape or arrangement. 37. Intervertebral disc implant according to claim 36, characterized in that after reaching the desired shape or arrangement of the intervertebral disc implant ( 1 ) in the intervertebral space, the pull wire ends ( 16 ) and / or ( 17 ) can be permanently fixed. 38. Intervertebral disc implant according to one of claims 31 to 37, characterized in that a pseudo-elastic shape memory alloy, which the desired shape or arrangement has previously been impressed, can be used as an implant material in whole or in part for the intervertebral disc implant ( 1 ).