CN100400014C - 椎间植入体 - Google Patents

椎间植入体 Download PDF

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CN100400014C
CN100400014C CNB028282159A CN02828215A CN100400014C CN 100400014 C CN100400014 C CN 100400014C CN B028282159 A CNB028282159 A CN B028282159A CN 02828215 A CN02828215 A CN 02828215A CN 100400014 C CN100400014 C CN 100400014C
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intervertebral implant
boring
retaining element
implant
dimensional structure
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CN1620271A (zh
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C·马蒂厄
C·M·J·凯恩
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AO Technology AG
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Synthes AG Chur
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Abstract

一种三维结构(10)形式的椎间植入体,它包括:(a)一个顶面(1)和一个底面(2),它们设计为靠在两个相邻椎骨的底板上;(b)一个左侧面(3)和一个右侧面(4);(c)一个正面(5)和一个背面(6);(d)一个位于顶面和底面之间的水平中心面;(e)一个位于左侧面和右侧面之间的垂直中心面(8);(f)多个穿过三维结构的钻孔(9),这些钻孔设计用于容纳纵向固定元件(20),这些元件的轴线(19)与水平中心面(7)相交。这样设计有至少一个钻孔,以使容纳在其中的纵向固定元件可以刚性地与椎间植入体相连。(g)所述三维结构在它的正面包括一个垂直于水平中心面配置的前板(8),所述钻孔穿过上述前板并且纵向固定元件能锚定在这个前板中;(h)所述前板相对于中心面能垂直移动地配置在三维结构中。所述连接使用螺纹或通过匹配锥面来实现。

Description

椎间植入体
技术领域
本发明涉及一种椎间植入体。
背景技术
这样的椎间植入体由英国专利申请文件GB 2207,607A是已知的,它公开了一种具有多个圆柱形孔的马蹄形植入体结构。这些孔配有光滑的内表面并且只包括一个用于待嵌在其中的接骨螺钉头部的挡块。此设计的缺点是,嵌入的固定螺钉仅仅可以通过它们的杆部锚定在骨头中,缺少与马蹄形椎间植入体的刚性连接。一旦在骨头中的接骨螺钉的锚定减弱,椎间植入体变得可相对于螺钉移动并且接骨螺钉就可移动而危及血管。此外椎间植入体的松开需要假性关节。
上述引用的现有技术状态仅仅阐明了本发明的技术背景,但是它没有暗示所引用的现有技术在本申请时或其优先权时已经被公开或为公众所知。
发明内容
本发明的目的是减轻痛苦。本发明创造了一种椎间植入体,该椎间植入体能够这样刚性地与骨固定装置连接,使得甚至在骨结构减弱时,也可以避免椎间植入体与骨固定装置之间的松开。
上述目的在本发明中通过一种上述类型的椎间植入体来实现。
按照本发明的椎间植入体,它为三维结构的形式,包括:(a)一个顶面和一个底面,它们适合于靠在两个相邻椎骨的端板上,(b)一个左侧面和一个右侧面,(c)一个正面和一个背面,(d)一个位于顶面和底面之间的水平中心面,以及(e)多个穿过三维结构的钻孔,这些钻孔容纳纵向固定元件并且包括与水平中心面相交的轴线,(f)至少其中一个钻孔设计为,使容纳在其中的纵向固定元件能刚性地与椎间植入体相连;其中,(g)所述三维结构在它的正面包括一个垂直于水平中心面配置的前板,所述钻孔穿过上述前板并且纵向固定元件能锚定在这个前板中;(h)所述前板相对于中心面能垂直移动地配置在三维结构中。
通过椎间植入体与纵向固定元件之间的刚性的、亦即牢固的连接,可以基本上得到本发明所提供的优点。基本上能够两个不同的实施方式用于获得刚性的连接是可行的。
在第一实施方式中,至少一个钻孔是内部有螺纹的。在这种情况下一个配有螺纹的相配的接骨螺钉可以刚性地旋入植入体中。
关于第二实施方式,前板安装在三维(3D)结构的前表面,以便与椎间植入体的水平中心面垂直,所述钻孔穿过所述正面板并且容纳锚定的纵向固定元件。与现有技术中的两部分植入体相比较,其中,前板是在单独各自的操作步骤中植入的,本发明的上述设计的优点是,椎间植入体可以在单一的步骤中并因此以简单和较快的方式植入。本发明另外的优点是,椎间植入体尽可能固定在椎骨的正面,也就是在可以期望好的骨材料的位置。由于前面的位移没有受到限制,由此不会导致比在使用现有技术的椎间植入体对周围组织产生更大的危险。负载仍然通过受压缩的椎间植入体承受,而不是通过前板或固定螺钉。
在本发明的另一实施方式中,前板可移动地配置在3D植入体结构中,以便它可以相对于该3D植入体结构垂直移动。“应力屏蔽”是通过这种方式得到的(也就是说保护免受或平衡机械应力),并由此在治疗过程中端板可以逐渐地与椎间植入体相配。
对于另一实施例,前板是由不同于3D椎间植入体的材料构成。
对于本发明的另一实施例,至少一个钻孔锥度呈圆锥形朝向它的下侧逐渐变细,并且其结果是设有相配的圆锥形头部的接骨螺钉刚性地锚定在所述钻孔中。优选钻孔的锥角小于合成的摩擦角。合适的是,钻孔的锥度为1∶3.75到1∶20.00,优选为1∶5到1∶15。
对于本发明的另一实施方式中,椎间植入体的侧面是基本凸出的。
合适的是,椎间植入体的顶面和/或底面不是平面而是凸起的。以这种方式可以得到更好地匹配于相邻椎骨的端板。
优选钻孔不穿过椎间植入体的左和右侧面。再次优选的的是,钻孔不穿过正面延伸。
对于本发明的另一优选实施例,至少两个钻孔是相互平行的。该特征使得在植入时易于嵌入椎间植入体。
对于本发明的另一优选实施例,如从正面观看的那样,至少两个钻孔是以彼此发散的方式延伸的。其结果是,接骨螺钉将移向比在椎骨中心具有更好骨质量的椎骨区域。合适的是,钻孔轴线与水平中心面相交成一个25°到70°,优选为35°到55°的角度。该特征提供了对插入螺钉的改善的接近。
对于本发明的另一实施方式,钻孔不穿越水平中心面。
取决于环境,二、三、四或甚至更多的纵向固定元件可刚性地与椎间植入体相连;合适的是,至少一个固定元件穿过顶面并且至少一个固定元件穿椎间植入体侧面。
纵向固定元件优选是包括头部和杆部的接骨螺钉,所述头部优选配有外螺纹,它与椎间植入体的钻孔的内螺纹相配。对于第二个适当的连接,优选可以使用一种其头部朝向杆部的方向成圆锥形地逐渐变细的接骨螺钉,头部的锥度与椎间植入体钻孔的相对应。
对于另一实施方式,至少两个纵向固定元件穿过顶面,并且至少两个纵向固定元件穿过底面。椎间植入体以这种方式最优化地锚定在相邻的椎骨中。
优选螺钉形的纵向固定元件具有自钻孔和自攻螺纹的外螺纹。纵向固定元件也可以设计为配有钻尖的没有螺纹的圆柱形销,优选为套针形式。
在另一变化实施例中,纵向固定元件是螺旋弹簧;最后,所述纵向固定元件也可以设计为单翼或多翼的螺旋叶。
在本发明的另一实施方式中,纵向固定元件尖端可以锚定在三维结构内,其结果是,纵向固定元件的头部可以锚定在相邻的椎骨中。
在本发明的另一实施方式中,纵向固定元件头部具有一加宽的直径;同样设有一用于头部的支承盘,以便靠在上述椎骨上。
椎间植入体可以由生理上兼容的材料构成,但合适的是,三维结构由生理上兼容的塑料组成,优选为非加强的塑料。由本发明提供的相对于已知的在植入技术中使用的纤维加强的塑料的优点是,将没有非加强的纤维-一种可能性就是临床不便。合适的是,一种由非加强的塑料组成的、其外螺纹具有11°到14°,优选为12°到13°的负载螺纹啮合角的接骨螺钉可以用在这样的三维结构中。负载螺纹啮合角的相对小的倾斜实现了高的夹紧力,其结果是,径向伸长和塑料破裂的危险降低了。合适的是,接骨螺钉的外螺纹使骨头具有一个6°到10°,优选为7°到9°倾斜角。该特殊的倾斜角产生了螺纹的自动锁定并且防止了接骨螺钉自己松开。
钻孔能够以金属套筒的形式配有一内螺纹,以便改善接骨螺钉在塑料植入体结构中的锚定。椎间植入体也可以部分由塑料而在在钻孔区域由金属组成。这种设计提供了改进的导向和接骨螺钉在椎间植入体中的锚定。
关于另一优选的实施方式,钻孔内壁是光滑的,金属的纵向固定元件的螺纹头部切入或攻入上述光滑壁中。
附图说明
在下面参考两个示例性实施例的部分示意图进一步阐述本发明及其实施方式。附图中:
图1示出包括带嵌件的接骨螺钉的椎间植入体的局部断面的透视图,
图2是图1的椎间植入体的正视图,
图3是图1的椎间植入体的侧视图,
图4是图1的椎间植入体的顶视图,
图5是带有前端嵌件的局部剖开的椎间植入体的正视图,
图6是图5的椎间植入体的垂直纵剖面,以及
图7是图5的椎间植入体的水平截面。
具体实施方式
图1到4的椎间植入体由展示有一个凸起的顶面1和凸起的底面2的三维(3D)结构10组成,这两个面分别被设计为靠在两相邻椎骨的端板上。为了得到改进的锚定,顶面1和底面2可以是局部解剖形的并且可以配有凹槽、肋或齿,或者它们的表面可以仅仅是粗糙的。
三维结构10还包括左侧面3和右侧面4,还有正面5和背面6。三维结构10也可以是中空的并且它的外表面可以包括穿孔。
三维结构10包括多个通过其中并容纳纵向固定元件20的钻孔。优选将设有四个这样的钻孔9。
至少一个钻孔9以这样设计,使得容纳在其中的纵向固定元件20刚性地与椎间植入体相连接。为此目的钻孔9是圆锥形的。
优选固定元件20是具有头部21和尖端22的接骨螺钉。头部21成圆锥形地朝向杆部23变细,头部21的锥度对应于钻孔9的锥度。此外,四个钻孔9配有内螺纹11。
关于在图5到图7中所示的实施例变型,三维结构10在其正面5上配有一个优选金属的嵌件8,固定元件20可以锚定在此嵌件中。嵌件8以可垂移动直的方式安装在三维结构10中。

Claims (34)

1.一种三维结构(10)形式的椎间植入体,包括:
(a)一个顶面(1)和一个底面(2),它们适合于靠在两个相邻椎骨的端板上,
(b)一个左侧面(3)和一个右侧面(4),
(c)一个正面(5)和一个背面(6),
(d)一个位于顶面(1)和底面(2)之间的水平中心面(7),以及
(e)多个穿过三维结构(10)的钻孔(9),这些钻孔容纳纵向固定元件(20)并且包括与水平中心面(7)相交的轴线(19),
(f)至少其中一个钻孔(9)设计为,使容纳在其中的纵向固定元件(20)能刚性地与椎间植入体相连;
其特征在于:
(g)所述三维结构(10)在它的正面(5)包括一个垂直于水平中心面(7)配置的前板(8),所述钻孔(9)穿过上述前板(8)并且纵向固定元件(20)能锚定在这个前板中;
(h)所述前板(8)相对于中心面(7)能垂直移动地配置在三维结构(10)中。
2.如权利要求1所述的椎间植入体,其特征在于,前板(8)由与三维结构(10)不同的材料制成。
3.如权利要求2所述的椎间植入体,其特征在于,前板(8)是金属的。
4.如权利要求1或2所述的椎间植入体,其特征在于,至少其中一个钻孔(9)包括一内螺纹。
5.如权利要求1或2所述的椎间植入体,其特征在于,至少一个钻孔(9)朝向底面(2)圆锥形地逐渐变细。
6.如权利要求5所述的椎间植入体,其特征在于,圆锥形钻孔(9)的锥角小于合成的摩擦角。
7.如权利要求6所述的椎间植入体,其特征在于,圆锥形钻孔(9)的锥度在1∶3.75到1∶20.00的范围内。
8.如权利要求1或2所述的椎间植入体,其特征在于,该椎间植入体的各侧面(1,2,3,4,5,6)都是凸出的。
9.如权利要求1或2所述的椎间植入体,其特征在于,顶面(1)和/或底面(2)是非平面的。
10.如权利要求1或2所述的椎间植入体,其特征在于,钻孔(9)既不穿过左侧面(3)也不穿过右侧面(4)。
11.如权利要求1或2所述的椎间植入体,其特征在于,钻孔(9)不穿过正面(5)。
12.如权利要求1或2所述的椎间植入体,其特征在于,其中至少两个钻孔(9)相互平行地延伸。
13.如权利要求1或2所述的椎间植入体,其特征在于,至少其中两个钻孔(9)从正面(1)看彼此发散。
14.如权利要求1或2所述的椎间植入体,其特征在于,钻孔(9)的轴线(19)与水平中心面相交成一个在25°到70°范围内的角度。
15.如权利要求1或2所述的椎间植入体,其特征在于,钻孔(9)不穿过水平中心面(7)。
16.如权利要求1或2所述的椎间植入体,其特征在于,该椎间植入体包括至少两个嵌在钻孔(9)内并配有一头部(21)和一尖端(22)的纵向固定元件(20),至少一个纵向固定元件(20)穿过顶面(1),并且至少一个纵向固定元件(20)穿过底面(2)。
17.如权利要求16所述的椎间植入体,其特征在于,所述纵向固定元件(20)是接骨螺钉,该接骨螺钉还具有一杆部(23)。
18.如权利要求17所述的椎间植入体,其特征在于,所述接骨螺钉的头部(21)配有一外螺纹,该外螺纹与钻孔(9)的内螺纹(11)相配合。
19.如权利要求17所述的椎间植入体,其特征在于,头部(21)朝向杆部(23)圆锥形地逐渐变细。
20.如权利要求16所述的椎间植入体,其特征在于,至少两个纵向固定元件(20)穿过顶面(1),并且至少两个纵向固定元件(20)穿过底面(2)。
21.如权利要求16所述的椎间植入体,其特征在于,纵向固定元件(20)是接骨螺钉,其杆部配有外螺纹。
22.如权利要求16所述的椎间植入体,其特征在于,纵向固定元件(20)是具有钻尖的没有螺纹的圆柱形销钉。
23.如权利要求16所述的椎间植入体,其特征在于,纵向固定元件(20)是螺旋弹簧。
24.如权利要求16所述的椎间植入体,其特征在于,纵向固定元件(20)是单翼或多翼的螺旋叶。
25.如权利要求16所述的椎间植入体,其特征在于,纵向固定元件(20)的尖端(22)能够以这样的方式锚定在三维结构(10)中,使纵向固定元件(20)的头部(21)能锚定在相邻椎骨中。
26.如权利要求25所述的椎间植入体,其特征在于,纵向固定元件(20)的头部(21)包括一加宽的直径,并且还有一支承盘(30),该支承盘设计为靠在椎骨上并设定用于上述头部。
27.如权利要求16所述的椎间植入体,其特征在于,三维结构(10)由塑料组成。
28.如权利要求18所述的椎间植入体,其特征在于,接骨螺钉(20)的外螺纹(25)包括一个在11°到14°范围内的负载螺纹啮合角。
29.如权利要求18所述的椎间植入体,其特征在于,接骨螺钉的外螺纹(25)具有一个6°到10°的倾斜角。
30.如权利要求1或2所述的椎间植入体,其特征在于,钻孔(9)包括一个带内螺纹(11)的金属套管。
31.如权利要求1或2所述的椎间植入体,其特征在于,该椎间植入体部分由塑料制成,并且在钻孔区域由金属制成。
32.如权利要求27所述的椎间植入体,其特征在于,钻孔(9)具有一光滑的内壁,金属的纵向固定元件(20)的螺纹头部能切入或结合在此内壁中。
33.如权利要求1或2所述的椎间植入体,其特征在于,该椎间植入体的顶面(1)和底面(2)是齿形的。
34.如权利要求1或2所述的椎间植入体,其特征在于,该椎间植入体是空心结构形式的,此空心结构的外表面是穿孔的。
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