CN100581506C - 椎间植入物 - Google Patents

椎间植入物 Download PDF

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CN100581506C
CN100581506C CN03826347A CN03826347A CN100581506C CN 100581506 C CN100581506 C CN 100581506C CN 03826347 A CN03826347 A CN 03826347A CN 03826347 A CN03826347 A CN 03826347A CN 100581506 C CN100581506 C CN 100581506C
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implant
ring
implant part
involutory
intervertebral implant
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CN1774219A (zh
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M·居特林
M·沙尔
B·莱赫曼
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AO Technology AG
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Synthes USA LLC
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Abstract

本发明涉及一种椎间植入物(1)，包括：A)一个下面的植入部分(2)，它具有一个包括一个空心圆柱形腔(3)和一条转动轴线(11)的外壳(14)以及一个用于贴靠到邻接的下椎骨的盖板面上的对合部分(4)；B)一个上面的植入部分(5)，它具有一个基本上圆柱形的杆(6)，该杆包括外螺纹(7)和转动轴线(11)，该杆(6)插入到腔(3)中并且具有一个用于贴靠到邻接的上椎骨的盖板面上的对合面(8)；其中C)两个植入部分(2、5)防止绕其转动轴线(11)的转动；以及D)一个在两个植入部分(2、5)之间设置的具有内螺纹(10)的环(9)，内螺纹(10)与外螺纹(7)相配合作用；其中E)两个植入部分(2、5)和环(9)共轴地沿其共同的转动轴线(11)设置，以致通过环(9)在杆(6)的外螺纹(7)上的旋转，可连续改变两个对合部分(4、8)之间的间距；并且环(9)轴向固定但可转动地与下面的植入部分(2)相连接。由于按照本发明的椎间植入物，一种简化的操作是可能的，其一方面提高安全性而另一方面缩短用于植入的时间耗费。

Description

椎间植入物
技术领域
本发明涉及一种椎间植入物。
背景技术
由DE-A 196 22 827已知一种此类的椎间植入物，其中，中间的构成为具有内螺纹的环的植入部分与上面的终端的植入部分只用螺纹相连接。相对于下面的终端的植入部分该环不仅可轴向移动而且可自由转动。下面的终端的植入物部分为环只用作轴向挡块，亦即作为支承面，环可以相对其旋转，从而可轴向移动上面的终端的植入物(螺母/螺杆传动)。因此两个终端的植入部分相互不固定地组装，其还示出，为了其轴向固定在两个植入部分之一中设有一径向的螺纹孔，借其导过一可拉紧的夹紧螺钉。因此该已知的椎间植入物的缺点是，其在手术前和手术内是不固定的并且可以相互分离。一个植入部分在手术室中的脱落由于要消毒的原因会导致显著的时间延迟。
由ULRICH氏的EP-A 1 219 266已知一种具有一个螺纹环的可伸缩的椎间假体，其具有一锥齿轮啮合，其从径可经由一小锥齿轮旋转。在该已知的装置中不利的是这种情况，即螺纹环并不与套筒部分之一轴向固定相连接。因此植入物的构成是不大稳定的并且还需要一专用的工具以便拉开植入物。该已知的植入物的另一缺点在于采用的锥齿轮啮合，其是不怎么“容忍的”并因而是不利的。在锥齿轮啮合的情况下驱动工具即使在一微小的轴向位移时已不再能感觉到其作用并且外科医生必须就地重新定位工具。
发明内容
在这里本发明将消除弊端。本发明的目的在于，提供一种椎间植入物，该椎间植入物在保持一个尽可能最小的结构高度情况下构成一小型的防止各个部分相互分离的整体并且可以作为预装组件供给外科医生使用。
根据本发明，提出一种椎间植入物，包括：A)一个下面的植入部分，该植入部分具有一个包括一个空心圆柱形腔和一条转动轴线的外壳以及一个用于贴靠到邻接的下椎骨的盖板面上的对合部分；B)一个上面的植入部分，该植入部分具有一个基本上圆柱形的杆，该杆包括外螺纹和转动轴线，该杆插入到下面的植入部分的腔中并且具有一个用于贴靠到邻接的上面的椎骨的盖板面上的对合部分；其中C)两个植入部分防止绕其转动轴线的转动；以及D)一个在两个植入部分之间设置的具有内螺纹的环，内螺纹与上面的植入部分的外螺纹相配合作用；其中E)两个植入部分和环共轴地沿其共同的转动轴线设置，以致F)通过环在杆的外螺纹上的旋转，可连续改变两个对合部分之间的间距；其特征在于，G)环轴向固定但可转动地与下面的植入部分相连接；以及H)环具有一个下面的、面向下面的植入部分的圆环表面和一个上面的、面向上面的植入部分的圆环表面，其中I)下面的圆环表面具有一个齿圈，该齿圈适合于容纳一个与其对应的小齿轮，并且J)圆柱形杆的外螺纹和环的内螺纹构成自锁的。
通过本发明达到的优点可看出基本上在于，由于按照本发明的椎间植入物，一简化的操作是可能的，其一方面提高安全性而另一方面缩短用于植入的时间耗费。
在一种特别的实施形式中，椎间植入物的环借助一卡式连接轴向固定但可转动地固定在下面的植入部分上。由此环为了驱动可靠地保持于适当的位置，亦即环不可能轴向偏移。
优选，卡式连接由一个在环中的环形内凹和一个与其对应的在下面的植入部分的外壳的自由端上的环形凸缘构成。借此这样保证环的转动，即如两个套筒形的植入部分那样绕相同的中心转动。
在另一种实施形式中，环具有一个下面的、面向下面的植入部分的圆环表面和一个上面的、面向上面的植入部分的圆环表面，其中下面的圆环表面具有一个齿圈，其适合于容纳一与其对应的小齿轮。该实施形式通过带有小齿轮的工具的径向转动允许环的轴向转动。与已知的其中环必须切向移动的植入物相比，得到的优点是，旋转工具的较小的空间需要和较高的速度，因为可以连续地旋转而不必要将旋转工具总是必须重新插入环的新孔中。
在另一种实施形式中，下面的植入部分的外壳具有一径向的、优选穿通的凹槽，其适合于相对于齿圈定位和支承一小齿轮。借此得到有利的可能性，即在完成椎骨的分离以后，骨碎片可通过穿通的凹槽插入下面的植入部分的腔中。
在另一种实施形式中，上面的植入部分的圆柱形杆6-为了防止上面的相对于下面的植入部分的转动-具有一平行于转动轴线延伸的导槽而下面的植入部分的外壳在其内面具有一向内凸出的嵌入导槽中的导向元件17，其优选可通过一径向通孔插入外壳中。因此避免两个植入部分的相互转动。相互转动会损害植入物对各终板的接触和脊柱前凸的角度。
在另一种实施形式中，上面的植入部分5的圆柱形杆6的圆周小于下面的植入部分2的空心圆柱形腔3，以致两个构件并不接触。
在另一种实施形式中，圆柱形杆的外螺纹和环的内螺纹构成自锁的。通过螺纹的自锁可以将植入物拉开到一任意的高度，而不需要为此附加的锁定。
在另一种实施形式中，外螺纹和内螺纹的螺距在0.5至1.0mm、优选在0.6-0.8mm的范围内。较大的螺距例如在2mm范围内显示手术内的缺点，因为拉开表明过于粗糙而较小的螺距造成较长时间的转动。
在另一种实施形式中，外螺纹和内螺纹均构成为右旋螺纹。由此得到的优点是，带有小齿轮的工具通常如同一标准的螺钉改锥可以用右手旋转，以便拉开植入物。
在另一种实施形式中，外螺纹和内螺纹均构成为多头的，优选为双头的螺纹。在一双头的螺纹中环的每一整转达到一双倍的行程。因此可较快和较简单地操作植入物，这缩短手术时间和维护病人。
在另一种实施形式中，两个对合部分构成为横向于转动轴线的板形元件，它们具有一个用于贴靠到邻接的椎骨的盖板面上的对合面。
在另一种实施形式中，各对合面不垂直于转动转轴设置而优选与转动轴线构成一个83°至85°的角度。借此更好地适应于解剖学上的情况。优选两对合面相互间夹一个10°至14°的角度。借此确定解剖学上的脊柱前凸角。
在另一种实施形式中，两个对合面的至少一个、优选上面的植入部分的对合面向外成拱形。借此最好地适应于椎骨体。下面的植入部分的对合面构成基本上平面的。
在另一实施形式中齿圈是铣直齿的。与锥形的/斜齿加工的齿圈相比铣直齿的是“更容忍的”。
附图说明
以下借助多个实施例的部分的示意图还要更详细地说明本发明及其进一步构成。其中：
图1椎间植入物处于组装状态的透视图；
图2椎间植入物处于拆开状态的透视图；
图3通过按图1的植入物的转动轴线的纵剖面图；
图4按图1的椎间植入物的正视图；
图5通过按图1的椎间植入物的转动轴线处于拆开状态的纵剖面图；
图6按图1的椎间植入物处于拆开状态的正视图。
具体实施方式
图1-6中示出的椎间植入物1基本上包括一个下面的植入部分2、一个上面的植入部分5和一个在两植入部分2、5之间设置的环9。下面的植入部分2具有一个包括一个空心圆柱形腔3和一条转动轴线11的外壳14以及一个用于贴靠到邻接的下椎骨的盖板面上的对合部分4。上面的植入部分5具有一个基本上圆柱形的杆6包括外螺纹7和转动轴线11，该杆6插入下面的植入部分2的腔3中并且具有一用于贴靠到邻接的上椎骨的盖板面上的对合部分8。两个植入部分防止绕其转动轴线11的转动。
环9具有一内螺纹10，其与上面的植入部分5的外螺纹7相配合作用，其中两植入部分2、5和环9共轴地沿其共同的转动轴线11设置，从而通过环9在杆6的外螺纹7上的旋转可连续改变两对合部分4、8之间的间距。环9借助一卡式连接轴向固定但可转动地与下面的植入部分2相连接。
如图3中所示，卡式连接包括一在环9中的环形内凹21和一与其对应的在下面的植入部分2的外壳14的自由端上的环形凸缘22。
环9具有一下面的面向下面的植入部分2的圆环表面12和一上面的面向上面的植入部分的圆环表面13，其中下面的圆环表面12具有一铣直齿的齿圈23，其适合于容纳一与其对应的小齿轮。
下面的植入部分2的外壳14具有一径向的穿通的凹槽15，其适合于相对于齿圈23定位和支承一(图中未示出的)小齿轮。
为了防止上面的植入部分5相对于下面的植入部分2的转动，上面的植入部分5的圆柱形杆6具有一个平行于转动轴线11延伸的导槽16而下面的植入部分2的外壳14在其内面具有一向内凸出的嵌入导槽16中的导向元件17(图2)，其可通过一个径向通孔18插入外壳14中。
圆柱形杆6的外螺纹7和环9的内螺纹10构成自锁的。外螺纹7和内螺纹10的螺距为0.7mm。外螺纹7和内螺纹10均构成为双头的右旋螺纹。
如图3中所示，两个对合部分4、8构成为横向于转动轴线11的板形元件，其具有一个用于贴靠到邻接的椎骨的盖板面上的对合面19、20，其中对合面19、20不垂直于转动轴线11设置而与转动轴线11夹一个85°的角度。因此两个对合面19、20相互间夹一个10°的角度。上面的对合面20向外成拱形，如图3中所示；而下面的植入部分的对合面19构成基本上平面的。
椎间植入物可以由通用的植入材料制造。优选采用X射线穿透的PEEK，以便借助X射线可以判断融合情况。
该椎间植入物特别适于用作为在脊柱的颈的和较高的胸廓区域内的椎骨体假体。

Claims (16)

1.椎间植入物(1)，包括：
A)一个下面的植入部分(2)，该植入部分具有
-一个包括一个空心圆柱形腔(3)和一条转动轴线(11)的外壳(14)，以及
-一个用于贴靠到邻接的下椎骨的盖板面上的对合部分(4)；
B)一个上面的植入部分(5)，该植入部分具有一个基本上圆柱形的杆(6)，该基本上圆柱形的杆包括外螺纹(7)和转动轴线(11)，该基本上圆柱形的杆(6)插入到下面的植入部分(2)的腔(3)中并且具有一个用于贴靠到邻接的上面的椎骨的盖板面上的对合部分(8)；其中
C)两个植入部分(2、5)防止绕其转动轴线(11)的转动；以及
D)一个在两个植入部分(2、5)之间设置的具有内螺纹(10)的环(9)，内螺纹(10)与上面的植入部分(5)的外螺纹(7)相配合作用；其中
E)两个植入部分(2、5)和环(9)共轴地沿其共同的转动轴线(11)设置，以致
F)通过环(9)在基本上圆柱形的杆(6)的外螺纹(7)上的旋转，可连续改变两个对合部分(4、8)之间的间距；
其特征在于，
G)环(9)轴向固定但可转动地与下面的植入部分(2)相连接；以及
H)环(9)具有一个下面的、面向下面的植入部分(2)的圆环表面(12)和一个上面的、面向上面的植入部分的圆环表面(13)，其中
I)下面的圆环表面(12)具有一个齿圈(23)，该齿圈适合于容纳一个与其对应的小齿轮，并且
J)基本上圆柱形的杆(6)的外螺纹(7)和环(9)的内螺纹(10)构成自锁的。
2.按照权利要求1所述的椎间植入物(1)，其特征在于，环(9)借助一种卡式连接轴向固定地但可转动地固定在下面的植入部分(2)上。
3.按照权利要求2所述的椎间植入物(1)，其特征在于，卡式连接由一个在环(9)中的环形内凹(21)和一个与其对应的在下面的植入部分(2)的外壳(14)的自由端上的环形凸缘(22)构成。
4.按照权利要求1至3之一项所述的椎间植入物(1)，其特征在于，下面的植入部分(2)的外壳(14)具有一个径向的凹槽(15)，该凹槽适合于相对于齿圈(23)定位和支承一个小齿轮。
5.按照权利要求4所述的椎间植入物(1)，其特征在于，凹槽(15)是穿通的。
6.按照权利要求1至3之一项所述的椎间植入物(1)，其特征在于，为了防止上面的植入部分(5)相对于下面的植入部分(2)的转动，上面的植入部分(5)的基本上圆柱形的杆(6)具有一个平行于转动轴线(11)延伸的导槽(16)，而下面的植入部分(2)的外壳(14)在其内面上具有一个向内凸出的、嵌入到导槽(16)中的导向元件(17)，该导向元件通过一个径向通孔(18)可插入外壳(14)中。
7.按照权利要求1至3之一项所述的椎间植入物(1)，其特征在于，上面的植入部分(5)的基本上圆柱形的杆(6)具有一个小于下面的植入部分(2)的空心圆柱形腔(3)的圆周，以致两个构件并不接触。
8.按照权利要求1所述的椎间植入物(1)，其特征在于，外螺纹(7)和内螺纹(10)的螺距在0.5至1.0mm的范围内。
9.按照权利要求1至3之一项所述的椎间植入物(1)，其特征在于，外螺纹(7)和内螺纹(10)均构成为右旋螺纹。
10.按照权利要求1至3之一项所述的椎间植入物(1)，其特征在于，外螺纹(7)和内螺纹(10)均构成为多头的螺纹。
11.按照权利要求1至3之一项所述的椎间植入物(1)，其特征在于，两个对合部分(4、8)构成为横向于转动轴线(11)的板形元件，它们各具有一个用于贴靠到邻接的椎骨的盖板面上的对合面(19、20)。
12.按照权利要求11所述的椎间植入物(1)，其特征在于，对合面(19、20)不垂直于转动轴线(11)设置。
13.按照权利要求12所述的椎间植入物(1)，其特征在于，两个对合面(19、20)相互间夹一个10°至14°的角度。
14.按照权利要求11所述的椎间植入物(1)，其特征在于，两个对合面(19、20)的至少一个对合面向外成拱形。
15.按照权利要求11所述的椎间植入物(1)，其特征在于，下面的植入部分的对合面(19)构成基本上平面的。
16.按照权利要求4所述的椎间植入物(1)，其特征在于，齿圈(23)是直齿的。
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