CN1578648A - 用于假体的骨锚固装置 - Google Patents

用于假体的骨锚固装置 Download PDF

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Publication number
CN1578648A
CN1578648A CN02821461.7A CN02821461A CN1578648A CN 1578648 A CN1578648 A CN 1578648A CN 02821461 A CN02821461 A CN 02821461A CN 1578648 A CN1578648 A CN 1578648A
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wing
prosthese
loading end
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CN1310624C (zh
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让·于佩尔
马克·阿梅伊
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LDR Medical SAS
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LDR Medical SAS
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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
    • 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
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
    • 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
    • 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
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
    • A61F2250/0062—Kits of prosthetic parts to be assembled in various combinations for forming different prostheses

Abstract

本发明涉及一种用于保持一个假体或者一个植入体在适当的位置上的骨锚固装置，尤其是一种椎间假体。因此本发明提出一种用于一个假体(1)或者植入体的锚固装置，该锚固装置通过压紧或者插入到预留在该骨表面上的一个狭缝(311，321)中从而固定到该骨表面(310，320)上。其特征在于，它包括至少一个延伸超出该假体的凸起件，该凸起件可以相对于假体在多个位置上定位，从而使得可以选择一个位置变为可能，该位置适于病例的治疗或者所选择的固定方式。

Description

用于假体的骨锚固装置
本发明涉及一种用于保持一个假体或者植入体在适当位置上的骨锚固装置，尤其是一种椎间的假体。
当一个内部假体装载在一个骨体上或者插入到几个骨体之间时，该假体的位置经常通过形成在该假体的一个面上的凸纹或不规则凸起保持在适当的位置上并且作为该骨体表面上的锚固装置。
对于椎间的假体，尤其是功能性置于一个椎间盘上的假体，该保持可以通过几种方式来保证。一个可能是由延伸超出假体表面的定位销组成，这些定位销在围绕假体的脊椎所施加的压力影响下包壳(encrusted)，或者压紧到脊椎盘表面内。
不过这些定位销的长度被这样的事实所限定，即两个椎骨必须足够分离从而允许假体和定位销插入到该间隙中。
为了获得更大的锚固深度，专利申请FR2659226公开了如何使用带有固定在翼形体上的一个或者几个凸起的假体，该假体延伸超出与椎骨相接触的平面并且沿着一个平行于脊柱的矢状面的平面定向。然后外科医生开始在脊椎盘的表面上钻开一个槽，其开口朝向脊椎体的一个侧面。该槽通过一个骨凿或者骨刀形成，并且其开口在一个对应于假体和它的翼状物插入方向的方向上朝向外侧。
由于翼状物的位置平行于矢状面，并且假如假体没有一个旋转的形状并且必须在围绕脊柱轴线的一个精确的角度位置上定向，因此假体必须根据一个在插入过程中允许中间介入的路径插入，通常为一个前侧的路径。
因此，本发明的目的是通过提供一种骨锚固装置来克服现有技术的不足，从而使得从不同的入口固定一个相同的假体变为可能，例如侧部进入，前侧部进入或者后侧部进入。
本目的通过一种用于假体或者植入体的锚固装置获得，该假体或者植入体通过压紧或者插入到一个预留在骨表面上的狭缝中而被锚固在该骨表面上，其特征在于它包括至少一个延伸超出该假体的凸起件，该凸起件可以相对于假体在多个位置上定位从而使得可以选择一个位置变为可能，该位置适于病例的治疗或者适于所选择的固定方法。
根据一个特征，凸起件是一个位于假体的几乎平的承载面上的翼状物，该翼状物沿着一个与该承载面不平行的平面具有一个细长的形状。
根据又一个特征，假体为一个椎间假体，该假体用于固定到至少一个脊椎的脊椎板间，翼状物可以围绕一个基本上垂直于假体的承载面或者脊椎板的轴线定位在多个角度位置上，多个角度位置由多个预留在假体承载面上的并与翼状物上的互补装置相配合的多个配合装置限定。
根据又一个特征，翼状物保持在一个角度位置上，该角度位置由翼状物上的并与假体上的互补形状相配合的至少一个不规则形状决定，或者由假体承载面上的并与翼状物上的互补形状相配合的一个不规则形状决定，或者由翼状物和承载面上的并互相配合的不规则形状决定。
根据又一个特征，翼状物具有一个沿着翼状物的平面固定并围绕一个与假体承载面为一体的定位销安装的钻孔，翼状物两个末端位置上的至少一个具有一个凸起部，该凸起部安装到一个预留在假体承载面上的狭缝中并保持翼状物的角度位置。
根据又一个特征，钻孔位于翼状物的中心部分或者一个末端位置上，该钻孔和定位销在形状为截头的并为互相互补的锥形状，并且具有足够小的角度来把定位销上的翼状物保持在适当位置上。
根据又一个特征，翼状物具有至少一个在它的厚度上的凹陷部，使得翼状物的两个表面互相连通。
根据又一个特征，翼状物在它的至少一个面的表面上具有不规则的形状，从而可以限制翼状物滑动到与骨质物相接触。
根据又一个特征，不规则形状是形成在翼状物顶部或者侧面上的锯齿状。
根据又一个特征，配合装置是预留在假体承载面上的孔，翼状物的互补装置是延伸超出翼状物与假体相接触的面的凸起。
根据又一个特征，配合装置是延伸超出假体承载面的凸起，翼状物的互补装置是预留在翼状物与假体相接触的面上的孔。
本发明以及它的特征和优点，在阅读了下面的描述并参照附图之后将变得清晰，其中：
图1示出了在定位翼状物之前一个盘状假体的透视图，该假体包括一个根据本发明的一个实施例的锚固装置，该锚固装置带有一个具有凹陷部的对称翼状物并允许四个角度定位；
图2a和2b示出了一个盘状假体的透视图，该假体包括根据本发明的一个实施例的锚固装置，该锚固装置带有一个具有凹陷部的对称翼状物并且允许两个角度定位，翼状物分别通过侧部进入或者中间进入来固定定位；
图3示出了一个通过侧部进入固定后位于两个椎骨之间的假体的侧视剖面图，该假体包括两个根据本发明的锚固装置，其中一个实施例中的一个锚固装置的翼状物不具有任何凹陷部；
图4示出了一个具有通过后侧部进入固定的假体的椎骨的横向剖视图，该假体包括一个根据本发明的一个实施例的锚固装置，该锚固装置带有不具有凹陷部的对称翼状物并允许四个角度定位。
本发明说明书涉及一种根据本发明的锚固装置，该锚固装置应用到一个功能型的脊椎盘假体上，意味着该锚固装置允许两个椎骨的相对移动。
虽然本发明在这儿是用于假体情况的描述，但是根据本发明的锚固装置可以应用到其它型式的装置上是明显的，例如用于非功能性的，例如用于胸关节固定罩或者肿瘤罩。在该说明书中，术语“假体”应该理解为等效于一个假体和一个植入体。
当锚固装置包括一个承载一个骨表面的部分时，根据本发明的锚固装置还可以用于保持其它型式的假体，并用于其它的原因以及身体的其它部位处。根据本发明的装置还可以结合其它的锚固装置，例如骨固定销或者螺丝。
在一个植入体是由一个肿瘤罩构成的情况下(没有显示)，用于锚固的装置，此后称之为“假体”，包括一个当该部分的主体坏死时，尤其是在肿瘤切除之后，用于代替一块椎骨或者一块椎骨的一部分的固定结构。
在图1所示的实施例中，一个用于脊椎盘的功能性假体1接受一个根据本发明的锚固装置。
假体包括两块用两个弯曲的侧面围绕一个神经核13的板111，112，这些侧面带有不同半径的曲率但是在相同的方向上定向。板以一种互补的方式在神经核的两侧承载，并且当两块板相对互相倾斜时曲率的不同允许神经核的侧向移动。围绕它的周边，板具有两对臂131，132，每个臂围绕一个与每块板为一体的支柱101，102。支柱具有一个比神经核的臂的开口宽的上部，并且与臂的开口相配合从而限定神经核的侧向和垂直移动，因此当板倾斜时阻止神经核的升高。
每块板111，112分别具有一个几乎平的外表面10，10′，称之为承载面。当位于如图3中所示的两个相邻的椎骨31，32之间的位置时，假体的每块板承载每块椎骨对置于另一块椎骨的部分，也就是说承载椎板310，320。
在根据本发明的接受锚固装置的盘上，板的外表面具有至少一个定位销12，优选地中心地并沿着垂直于该表面的方向延伸。一个细长的翼状物2沿着一个不平行承载面10的平面，例如垂直于该承载面的平面围绕该定位销安装。该翼状物包括一个位于它的边缘上的钻孔20，该钻孔围绕定位销12并且与定位销配合从而阻止翼状物2在平行于承载面10的一个平移平面内的任何移动。有利地，翼状物上的钻孔20与该翼状物接受的定位销12具有几乎互补的截头形状。这些形状具有一个足够小的锥形的角度从而使得它们的锁定允许把翼状物保持在定位销上，尤其是在操作和固定假体的过程中。优选地，承载面在它的中心区域包括一个定位销12，并且翼状物的钻孔20位于该中心部分上。因此在承载面上围绕所述定位销以多个角度位置把翼状物定位在定位销上是可能的。假体还包括多个能够通过与翼状物上的互补装置相互配合来限定角度位置的配合装置。
在另一个实施例(没有显示)中，翼状物钻孔20位于靠近它的末端位置处或者翼状物的边缘的任意位置处。
例如，配合装置是预留在假体的承载面10上的狭缝。翼状物2的互补装置是位于翼状物的其中一个末端位置上，或者两个末端位置上，或者对置于假体承载面10的面上的一个或者几个凸起部。
在这里所示的实施例中这些狭缝是预留在假体承载面上的孔101-108，这些凸起部是位于翼状物末端位置处的凸起21，22。在安装到承载面销上的翼状物的一定的角度位置上，这些凸起21，22插入到预留在该相同的承载面上的孔中。例如当插入假体时，这些孔101，105与翼状物上的凸起相配合从而保持翼状物围绕定位销12的角度位置。
在一个变化的实施例(没有显示)中，配合装置为凸起部，例如假体承载面上的凸起。互补装置为预留在与假体相接触的翼状物的表面上狭缝，例如孔。在该变形的实施例中，应该注意的是通过在脊椎压力的影响下压紧在脊椎盘中，假体上的没有被翼状物使用的凸起共同作用从而保持假体在适当的位置上。
在图1所示的实施例中，假体1的上板111在它的承载面10上具有八个为一组的孔，这些孔以相同的圆周围绕定位销12并且之间间隔角度45°。通过把翼状物2上的凸起插入到两个在直径上对置的任何一对孔中，从而使把翼状物定位到由这些孔对所限定的任何一个角度位置上变为可能。在图1所示的实施例中，如果翼状物对称地围绕定位销，则八个孔允许四个不同的角度位置，即0°，45°，90°，135°，如果翼状物为不对称的，则具有八个位置。如果其中这些孔对中的一对对应于矢状面，则翼状物的这四个位置(图4中的2a，2b，2c，2d)使得通过中间进入，前侧部进入，侧部进入或者后侧部进入使相同的翼状物插入到相同的假体中变为可能。
在图2a和2b所示的实施例中，根据本发明的锚固装置包括四个孔101，103，105，107，并且使得把翼状物插入到两个角度位置变为可能。图2a示出了通过中间进入来固定安装的翼状物，图2b示出了通过侧部进入来固定安装的翼状物。
应该可以清楚的理解，本发明还使得带有锚固装置的仅仅一个假体可以具有几种不同的固定方法变为可能，因此减低了生产类型的数量以及库存的数量。
在插入假体之前，以槽的型式出现的狭缝311，321分别在每块脊椎板310，320的表面上是中空的。例如，该狭缝以这样的一种方式进行制造，即该狭缝仅仅开口朝向一个单侧311，如图4所示，并且沿着固定假体的相同侧定向。
固定时翼状物可以从脊椎板侧滑入到该槽中，从而使假体不用离开椎骨太远就可以到达它的限定位置。
根据本申请，翼状物可以具有一个或者几个凹陷部23，24，使两个对置面相互连通。这些凹陷部例如可以被骨质物填充，这些骨质物由槽311的两侧重新组合而成。因此该填充允许保持翼状物被固定在脊椎板的适当位置上。
翼状物2还可以在它的一个或者几个侧面具有不规则的形状，例如V形切口或者锯齿状25，该不规则形状使得通过固定到所述槽的壁上而限制滑动到槽311中变为可能。在翼状物的一个或者几个侧面上，翼状物2还包括一个防滑面，该防滑面例如通过直接铸造，表面刻印，或者覆层而获得。尤其是，这样的一个表面可以在热结构钛下产生。
对于本领域的技术人员来说是显而易见的，本发明允许实施例在不超出本发明申请权利要求中所要求的范围下有许多其它的具体型式。因此，本发明实施例必须理解为仅仅为示例的，它们可以在附属的权利要求所限定的范围内进行变化，并且本发明并不仅限于上述所给的细节。

Claims (11)

1.一种用于一假体(1)或者一植入体的锚固装置，通过压紧或插入到一个预留在一个骨头表面上的狭缝(311，321)中来固定在该骨头表面(310，320)上，其特征在于，它包括至少一个延伸超出该假体的凸起件，该凸起件可以相对于假体在多个位置上定位，因而使得选择一个位置变为可能，该位置适合于所要治疗的病例或者适合于所选择的固定方法。
2.根据权利要求1所述的锚固装置，其特征在于，凸起件是被假体的一个几乎平的承载面(10)支撑的一个平的翼状物(2)，该翼状物沿着一个与该承载面不平行的平面具有一个细长的形状。
3.根据前述任一项权利要求中所述的锚固装置，其特征在于，假体(1)是一个用于固定到至少一个椎骨(31，32)的脊椎板(310，320)上的椎间假体，翼状物(2)可以围绕一根几乎垂直于假体承载面(10)或者脊椎板的轴线(d1)在多个角度位置(2a，2b，2c)上定位，多个角度位置由多个配合装置限定，这些配合装置预留在假体承载面上并与翼状物上的互补装置相配合。
4.根据权利要求2或3所述的锚固装置，其特征在于，翼状物(2)保持在一个角度位置上，该角度位置由翼状物上的并与假体上的互补形状相配合的至少一个不规则形状决定，或者由假体承载面上的并与翼状物上的互补形状相配合的一个不规则形状决定，或者由翼状物和承载面上的并相互配合的不规则形状决定。
5.根据权利要求2-4中任一项所述的锚固装置，其特征在于，翼状物(2)具有一个沿着翼状物的平面设置并围绕一个与假体的承载面(10)为一体的定位销(12)安装的钻孔(20)，翼状物的两个末端位置中的至少一个具有一个凸起部(21，22)，该凸起部用于安装到预留在假体的承载面上的狭缝(121，125)中从而保持翼状物的角度位置。
6.根据权利要求2-4中任一项所述的锚固装置，其特征在于，钻孔(20)位于翼状物(2)的中心部分或者一个末端位置上，该钻孔和定位销(12)在形状上为截头状并为相互配合的锥形状，并且具有足够小的角度来保持定位销上的翼状物在适当的位置上。
7.根据权利要求2-6中任一项所述的锚固装置，其特征在于，翼状物(2)具有至少一个在它的厚度上的凹陷部(21，22)，从而使得翼状物的两个表面可以连通。
8.根据权利要求2-7中任一项所述的锚固装置，其特征在于，翼状物(2)在它的至少一个面的表面上具有不规则形状(25)，从而可以限制翼状物滑动到与骨质物相接触。
9.根据权利要求8所述的锚固装置，其特征在于，不规则形状(25)为形成在翼状物的顶部或者侧面上的锯齿状。
10.根据权利要求3所述的锚固装置，其特征在于，配合装置是预留在假体的承载面(10)上的孔(101-108)，翼状物(2)的互补装置是延伸超出与假体相接触的面的凸起(21，22)。
11.根据权利要求3所述的锚固装置，其特征在于，配合装置是延伸超出假体的承载面的凸起，翼状物的互补装置是预留在翼状物与假体相接触的面上的孔。
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US7056344B2 (en) 2006-06-06
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AU2002348965A1 (en) 2003-05-19
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ES2314109T3 (es) 2009-03-16
RU2299708C2 (ru) 2007-05-27
WO2003039400A2 (en) 2003-05-15
ATE407645T1 (de) 2008-09-15
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