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Publication numberCN1541082 A
Publication typeApplication
Application numberCN 02810648
PCT numberPCT/US2002/008845
Publication date27 Oct 2004
Filing date22 Mar 2002
Priority date27 Mar 2001
Also published asCA2441767A1, CN100358485C, DE60238242D1, EP1372540A1, EP1372540A4, EP1372540B1, US6368351, US7621951, US8097035, US20040059421, US20100076491, WO2002076351A1
Publication number02810648.2, CN 02810648, CN 1541082 A, CN 1541082A, CN-A-1541082, CN02810648, CN02810648.2, CN1541082 A, CN1541082A, PCT/2002/8845, PCT/US/2/008845, PCT/US/2/08845, PCT/US/2002/008845, PCT/US/2002/08845, PCT/US2/008845, PCT/US2/08845, PCT/US2002/008845, PCT/US2002/08845, PCT/US2002008845, PCT/US200208845, PCT/US2008845, PCT/US208845
Inventors布雷德利J格伦, 布雷德利J・格伦, な┠蔚侣, 加里A施奈德曼
Applicant德普伊阿克罗米德公司
Export CitationBiBTeX, EndNote, RefMan
External Links: SIPO, Espacenet
Intervertebral space implant for use in spinal fusion procedures
CN 1541082 A
Abstract  translated from Chinese
提供一种植入物装置(10),用于将其外科植入椎间空间(S)中,例如用于在脊柱融合手术期间稳定邻近该椎间空间(S)的椎骨。 Provide an implant device (10) for its surgical implants intervertebral space (S), for example in stable during spinal fusion surgery adjacent to the intervertebral space (S) of the vertebrae. 植入物装置(10)包括一个与一第二部件(60)分开的第一部件(20)。 The implant device (10) comprises a first member and a second member (60) separated (20). 这些部件(20,60)是细长而截面足够小的,以便它们能以侵害最小的方式后植入。 These components (20,60) are elongated and sufficiently small cross-section, so that they can be implanted after the smallest violation. 第一部件(20)最好包括一孔道(30),而第二部件(60)最好包括一颈部(70),孔道(30)和颈部(70)的尺寸是互补的,使得当其在颈部(70)于孔道(30)中相交时部件(20,60)能互相稳定。 A first member (20) preferably comprises a bore (30), and a second member (60) preferably comprises a neck portion (70), bore (30) and a neck (70) of complementary dimensions such that when the its neck (70) at the bore (30) intersecting members (20,60) to each other stably. 这样提供的整个植入物装置(10)既能扩大又能支撑椎间空间(S),并足够刚性而能当椎骨(V)融合在一起时对椎间空间(S)提供充分的支撑。 This provides the entire implant device (10) can support both expand the intervertebral space (S), and sufficient rigidity can become a vertebra (V) together when the intervertebral space (S) to provide adequate support.
Claims(20)  translated from Chinese
1.一种用于在椎间空间中进行外科手术安置如脊柱融合手术期间的安置的植入物,该植入物包括以下组合:一个具有在一远端和一近端之间的细长形状的第一部件;一个具有在一第一端和一第二端之间的细长形状的第二部件;以及所述第二部件的在所述第一端和所述第二端之间的一部分与所述第一部件在所述远端和所述近端之间交叉。 Having an elongate between a distal end and a proximal end of: 1. A method for performing a surgical procedure, such as placement in the intervertebral space spinal fusion implant placement during surgery, the implant comprises a combination of the following said first end and said second end and said second member; a second elongate member having a shape between a first end and a second end; a first shaped member The portion of the first member between said distal end and said proximal end cross.
2.权利要求1的植入物,其特征在于,所述第一部件和所述第二部件两者的在顶面和底面之间的高度大于所述两部件的两侧面之间的宽度,使得所述两部件围绕一长轴从其中所述顶面沿侧向与所述底面间隔的取向到其中所述顶面在所述底面之上的取向的转动导致所述两部件的高度的增大。 The implant according to claim 1, characterized in that the height of the second member of both the first member and between said top and bottom surfaces of the side surfaces is larger than the width between the two members, so that the two parts around a major axis from which the orientation of the top surface and the bottom surface spaced laterally into which the top surface of the orientation of the rotation on the bottom surface of the lead to a high degree of growth of the two parts Great.
3.权利要求1的植入物,其特征在于,至少所述两部件之一的至少一部分是充分开口的,以允许所述两部件之另一部件至少部分穿过所述开口部分,使得所述两部件至少部分联锁在一起。 The implant of claim 1, wherein at least one of said at least a portion of the two members sufficiently open to allow another member of the two members at least partially through the opening portion, so that the said at least part of the two parts interlock together.
4.权利要求3的植入物,其特征在于,所述开口部分足够大,使得所述两部件基本上共平面。 The implant of claim 3, wherein said opening portion is sufficiently large, such that the two members substantially coplanar.
5.权利要求4的植入物,其特征在于,所述第一部件的在一顶面和一底面之间的高度等于所述第二部件的在一顶面和一底面之间的高度,使所述第一部件的所述顶面与所述第二部件的所述顶面共平面,而所述第一部件的所述底面与所述第二部件的所述底面共平面。 4. The implant of claim wherein the height of the first member between a top surface and a bottom surface of the second member is equal to the height between a top surface and a bottom surface, said top surface of said first member and said top surface coplanar with said second member, said bottom surface and said bottom surface of said first member and said second member coplanar.
6.权利要求3的植入物,其特征在于,所述第一部件在所述远端和所述近端之间是至少部分开口的,而所述第二部件在所述第一端和所述第二端之间是至少部分开口的,所述第一部件中的所述开口邻近所述第二部件中的所述开口,在该处所述第二部件与所述第一部件交叉,使得所述第一部件和所述第二部件至少部分联锁在一起。 The implant of claim 3, wherein said first member between said proximal end and said distal end is at least partially open, and said second member at said first end and between said second end is at least partially open, the second member adjacent the first member in the opening of the opening, where the first member and the second cross member such that the first member and the second member is at least partially interlock together.
7.权利要求6的植入物,其特征在于,所述第一部件的所述开口是一个在顶面和底面之间的孔道,所述孔道至少像所述第二部件的在所述第一端和所述第二端之间的至少一部分那样大,使得所述第二部件能够被配置成穿过所述孔道而延伸。 The implant of claim 6, wherein said opening of said first member is a tunnel between the top and bottom surfaces, at least the image of said second bore of said first member at least a portion between the one end and the second end as large, so that the second member can be configured to extend through the bore.
8.权利要求7的植入物,其特征在于,所述第二部件包括一个在所述第一端和所述第二端之间的颈部,所述颈部在所述第二部件的顶面和底面之间的高度小于邻近所述颈部的所述第二部件的其它部件的高度,所述颈部的高度小于所述第一部件中所述孔道的高度,使得所述第二部件的所述颈部能够被配置成穿过所述第一部件的所述孔道而延伸。 The implant of claim 7, wherein said second means comprises a neck portion at said first end and said second end, said neck portion of said second member height of the other components of the height between the top and bottom surfaces adjacent the neck portion is smaller than the second member, the height of the neck portion is smaller than the first height of said channel member, such that the second the neck member can be configured to pass through the bore of the first member extends.
9.权利要求1的植入物,其特征在于,所述第一部件包括一顶部构造和一底部构造,所述顶部构造和底部构造可相对移动,使得所述第一部件的高度可以变化。 The implant of claim 1, wherein said first member includes a top structure and a bottom structure, the top and bottom of the structure are relatively movable structure, so that the height of the first member may vary.
10.权利要求9的植入物,其特征在于,所述第一部件包括一个在所述顶部构造和所述底部构造之间的间隔物,所述间隔物使所述顶部构造移动而离开所述底部构造,从而增大所述第一部件的高度。 9 while leaving the implant as claim, wherein said first member includes a top structure and said spacer between said base structure, said spacer moving said top structure said base structure, thereby increasing the height of the first member.
11.权利要求10的植入物,其特征在于,所述间隔物是一个其顶端高度小于尾部高度的填隙片,所述第一部件包括一个至少部分延伸通过在所述顶部构造和所述底部构造之间的所述第一部件的通道,所述通道在一锥形区内有一较小的高度,所述锥形区比所述近端更接近所述远端,所述填隙片在所述锥形区处的高度大于所述通道的高度,使得当所述填隙片移动通过所述通道而进入所述锥形区时离开所述底部构造。 11. The implant of claim 10, wherein said spacer is a height less than the top end of the rear height shims, said first member comprises an at least partially extending through the top of the structure and channel configuration between the bottom of the first member, said passage at a tapered region having a smaller height, the tapered region closer to the distal end than the proximal end, said shim the height of the tapered zone is greater than the height of said passage, leaving the bottom structure such that when the sheet moves through the interstitial passageway into the tapered region.
12.权利要求9的植入物,其特征在于,所述顶部构造和所述底部构造在所述第一部件上的一个位置处枢轴式地连接在一起,该位置比所述远端更接近所述近端。 12. The implant of claim 9, wherein a position of said top and said bottom structure configured on the first member pivotally connected together, the position of the distal end of the more than proximity to the proximal end.
13.权利要求12的植入物,其特征在于,所述第二部件包括一顶部颚片和一底部颚片,所述顶部颚片可相对于所述底部颚片而移动,所述顶部颚片和所述底部颚片在一位置处枢轴式地连接在一起,该位置比所述第二部件的所述第一端更接近所述第二部件的所述第二端。 13. The implant of claim 12, wherein said second jaw member includes a top piece and a bottom piece jaw, said top jaw pieces may be moved relative to said bottom jaw pieces, said top jaw sheet and said bottom sheet at a position jaw pivotally connected together, the position of the second member closer to the second end than the first end of the second member.
14.权利要求13的植入物,其特征在于,所述第一部件中的所述枢轴和所述第二部件中的所述枢轴每个都是扩张枢轴,它们允许邻近所述枢轴的所述构造的部分进行枢轴摆动和垂直移动两种运动。 14. The implant of claim 13, wherein said pivot axis of said pivot axis of said first member and said second member are each pivotally expansion, which allow the adjacent Part of the structure was pivotal swing pivot and move vertically in two sports.
15.一种用于椎间空间的植入物,该植入物包括以下组合:一个具有在一远端和一近端之间的细长形状的第一部件;一个具有在一第一端和一第二端之间的细长形状的第二部件;所述第二部件的在所述第一端和所述第二端之间的一个部分与在所述远端和所述近端之间的所述第一部件相交;所述第一部件包括一个在所述远端和所述近端之间从侧面通过其间的孔道;所述孔道的高度小于所述第一部件的高度;所述第二部件包括一个在其所述第一端和所述第二端之间的颈部;所述顶部的高度小于所述第二部件的邻近所述颈部的那些部分;以及所述颈部的高度至少像所述第一部件中所述孔道的高度一样小,使得所述第二部件中的所述颈部能够配置成通过所述第一部件中所述孔道而延伸。 15. An implant for intervertebral space, the implant comprising in combination: a first member having a distal end and a proximal end between a pair of elongate shape; having at a first end and the second elongate member between a second end shape; and a portion of said second member between said first end and said second end and said distal end and said proximal end The intersection between the first member; the first means comprises a between the distal end and the proximal end side from the through bore therebetween; a height less than the height of the bore of the first member; the second member includes a neck portion thereof between said first end and said second end; the height of the top is smaller than that of said neck portion adjacent said second member; and the at least the height of the neck as the first member in the bore as small a height such that the neck portion of the second member can be configured through the bore in the first member extends.
16.权利要求15的植入物,其特征在于,所述第二部件的所述颈部的尺寸允许当所述颈部在所述第一部件的所述孔道内时所述第二部件能够围绕其长轴转动至少90度。 16. The implant of claim 15, wherein said dimension of said neck portion when said second member allows the neck portion in the bore of the first member and the second member capable of rotated about its major axis at least 90 degrees.
17.权利要求16的植入物,其特征在于,所述第一部件包括一顶部构造和一底部构造,所述顶部构造在一比所述远端更接近所述近端的位置处枢轴式连接在所述底部构造上,而所述第二部件具有一个在其一比所述第一端更接近所述第二端的位置处枢轴式连接在一个底部颚片上的顶部颚片。 Position of the pivot 17. The implant of claim 16, wherein said first member includes a top structure and a bottom structure, said top structure at a distal end than the proximal end is closer to the Connectors on the base structure, and said second jaw member having a top sheet in a one closer to the second end than the first end pivotally connected at a position on a bottom jaw piece.
18.一种椎间空间植入物,包括以下组合:一个具有在一远端和一近端之间的细长形状的第一部件;一个具有在一第一端和一第二端之间的细长形状的第二部件;以及至少所述部件之一在其两端之间的一个位置上至少部分地开口,使得所述第一部件和所述第二部件在其交叉处至少部分地联锁。 18. An intervertebral implant space, comprising in combination: a first member having a distal end and an elongated shape between the proximal end; having between a first end and a second end The elongated shape of the second member; and said at least one member in a position between its ends at least partially open, such that the first member and the second member at least partially their intersections Interlock.
19.权利要求18的植入物,其特征在于,所述第一部件和所述第二部件在其两端间包括一个至少部分开口的区域。 19. The implant of claim 18, wherein said first member and said second member comprises an at least partially open area between its ends.
20.权利要求18的植入物,其特征在于,所述第一部件包括一个在所述远端和所述近端之间从侧向穿过其间的孔道,所述第二部件包括一个在所述第一端和所述第二端之间的颈部,所述第二部件中的所述颈部的尺寸小到足以穿过所述第一部件中的所述孔道。 20. The implant of claim 18, wherein said first member includes a distal end and said proximal end between said laterally therethrough from the bore, the second member comprises a said neck portion of said first end and a second end, the small size of the second member sufficient to pass through the neck of the bore of the first member.
Description  translated from Chinese
供脊柱融合手术中使用的椎间空间植入物 For use in spinal fusion surgery intervertebral space implant

技术领域 Technical Field

本发明涉及植入物,其形状能安置在从相邻的脊柱椎骨之间的椎间空间内移去一椎盘后的该椎间空间中并便于使椎骨融合在一起。 The present invention relates to an implant, which can be arranged in the shape removed from the intervertebral space between adjacent vertebrae of a spinal vertebra late the intervertebral space and facilitates the vertebrae together. 更具体地说,本发明涉及能以侵害最小或开口最小的方式从后部植入,并使与该椎间空间相邻的椎骨彼此分开地扩展而重新创造腰脊柱前凸,且当椎骨融合在一起时支撑这些椎骨。 More particularly, the present invention relates to usurp the minimum or minimal way from the back of the implant opening, and the intervertebral space between adjacent vertebrae separated from each other and expand recreate lumbar lordosis, and when the vertebrae fusion support the vertebrae together.

技术背景已知脊柱融合手术是某些脊柱疾病的有效治疗方法。 BACKGROUND ART Known spinal fusion surgery is an effective treatment for certain spinal disorders. 通常,此种脊柱融合手术可能涉及移去两块相邻椎骨之间的椎间空间中的椎间盘。 Typically, such a spinal fusion surgery may involve intervertebral space between the vertebrae in the two adjacent disc is removed. 在已移去该椎盘后,可以在该椎间空间中安置一个植入物来推动两边的椎骨分开。 It has been removed and the vertebral disk, you can place an implant in the intervertebral space to push both sides of the vertebrae apart. 通过推动椎骨分开,椎骨周围的韧带和其它人体构造受到张力而往往与植入物一起将这两块椎骨牢固地保持在彼此相对的固定位置中。 By pushing apart the vertebrae, ligaments and other body constructed by the vertebrae surrounding this tension and often two vertebrae with the implant securely held in a fixed position relative to each other in. 尽可能恢复该椎间空间的高度是重要的。 As much as possible to restore the height of the intervertebral space is important. 恢复该椎间空间的角度或“脊柱前凸”也是重要的。 Recovery angle of the intervertebral space or "lordotic" is also important. 最后,将融合材料安置在该椎间空间内,该融合材料能诱生该椎间空间中的骨头生长,从而与通常保持埋置在该融合的椎骨组合中的植入物一起有效地融合这两块椎骨。 Finally, the integration of material disposed within the intervertebral space, the fusion material that can induce bone growth in the intervertebral space, which usually remain embedded in the vertebrae of the fusion implant combinations together effectively integrate this two vertebrae.

将植入物安置在椎间空间中是以两种普遍方法之一完成的。 The implant is placed in one of two common methods performed in the intervertebral space. 第一种方法是通过对病人进行腹部/胸部外科手术并从病人前侧接近该椎间空间,可以从前部接近该椎间空间。 The first way is through the patient abdomen / chest surgery and a patient side from the front approaching the intervertebral space, you can be close to the front of the intervertebral space. 在该前部手术中,通常涉及主要的腹部/胸部外科手术。 In the front part of the surgery, usually it involves major abdominal / thoracic surgery. 但是,通常能从前部接近该椎间空间,从而大大降低损伤神经的风险,而且外科手术在将植入物精确地安置于所要部位方面具有更大的灵活性。 However, usually closer to the front of the intervertebral space, thereby greatly reducing the risk of nerve damage, and surgery in the precise placement of the implant with greater flexibility in terms of the desired site.

第二种方法是,该植入物能够从后部插入。 The second method is that the implant can be inserted from the rear. 直接的后部接近该椎间空间要求向着中线移动椎管内的脊柱神经并可能导致损伤神经或结疤。 Direct proximity of the rear within the intervertebral space requirements toward the middle movement of the spinal canal and spinal nerves can cause nerve damage or scarring. 在椎间空间中的植入也能够从脊柱左侧或右侧的位置接近并以一个角度伸入椎间空间中。 In the intervertebral space can be implanted in the spine from a position close to the left or right at an angle and extending into the intervertebral space. 该途径避开了椎管。 The way to avoid the spinal canal. 能够使用一种利用小切口的侵害最小的方法,但必须小心完成以避开敏感的脊柱构造。 You can use a use a small incision against the smallest way, but care must be taken to avoid the sensitive spinal complete construction. 此外,由于椎骨构造之间的间隙量很小,通常需要尺寸较小的植入物。 Further, since the gap between the small amount of the vertebrae structure, usually require a smaller size implant. 因此,椎骨与一个后部植入物的扩展量常常不够充分。 Therefore, the amount of the vertebrae and a rear extension implant is often inadequate. 此外,通常需要至少部分切开一部分椎骨,以提供在将植入物从后部插入椎间空间中所必需的通道。 In addition, usually it requires at least a partially cut portion of the vertebra, in order to provide an implant into the intervertebral space required in the rear channels.

用于椎间空间的植入物有各种不同构型,大多数设计用于前植入。 The implant for the intervertebral space of a variety of different configurations, most of the design for the front implantation. Sertich的美国专利No.5,800,550详细描述了一种已知的先有技术植入物。 U.S. Patent No.5,800,550 Sertich the detailed description of a known prior art implants. Sertich植入物做成从后部植入并分成两部件。 Sertich implants implanted and divided into two parts made from the rear. 在脊柱的两侧做两个独立的切口,将整个植入物的两部件基本上互相平行地插入,但可以稍许偏离平行方向一个角度。 On either side of the spine do two separate incision, the two components are substantially the entire implant is inserted in parallel to each other, but can slightly deviate from the parallel direction at an angle. Sertich植入物的两部件具有矩形截面和细长形状。 Sertich two parts of the implant has a rectangular cross section and elongated shape. 两部件首先以较小的尺寸垂直取向地植入,使得两部件能够容易地进入椎间空间。 First of two parts to a smaller size of the vertical orientation to the implant, so that the two parts can easily enter the intervertebral space. 两部件然后旋转90度,使得较大的尺寸转到垂直方向,以便沿垂直方向扩展椎骨以增大椎间空间。 Two parts then rotated 90 degrees, so that the larger dimension to the vertical direction, so as to extend in the vertical direction to increase the vertebrae the intervertebral space.

Sertich说明的植入物不完全理想。 The implant is not entirely satisfactory Sertich explained. 因为Sertich植入物涉及两个完全独立的部件,所以它们无论怎样也不会彼此稳定,因而不能提供理想份量的椎骨稳定。 Because Sertich implant involves two completely separate parts, so they will not be stable no matter how each other, and therefore can not provide the desired amount of vertebral stability. 此外,两部件植入的相当平行的角度需要移去一部分椎骨和卷缩脊柱神经,以合适地植入Sertich植入物的两部件。 In addition, the two components implanted quite parallel angles need to remove part of the vertebrae and the spinal nerves crimped to fit implants implanted Sertich two parts thereof. 如果植入物的两部件彼此角度更大,它们提供给椎骨的稳定性往往进一步减小。 If the two parts of the implant angle to each other more, they provide stability to the vertebra often further reduced. 同时,Sertich植入物两部件的尺寸要求相当大的切口来插入到椎间空间内。 Meanwhile, Sertich implant member size requirements were both relatively large incision to insert into the intervertebral space.

因此,需要一种在插入时具有小的截面而一旦安置后还能在相邻的椎骨间提供大的位移量的后置的椎间空间植入物。 Thus, a need exists in having a small cross-section is inserted and once placed can provide a large rear space of the intervertebral implant in the amount of displacement between adjacent vertebrae. 该植入物必须扩张得足够远地分开以恢复该椎间空间的高度,并在完成移植后基本上起该椎间空间内一个单独的刚性构造的作用。 The implants must be separated far enough expansion to restore the height of the intervertebral space, and after completion of transplantation substantially act within the intervertebral space of a single rigid structure. 这样一种发明的额外优点是能够在前区中具有更大的高度,使得能够以外科手术所要的量来获得脊柱前凸,使椎间空产的前侧大于椎间空间的后侧。 An additional advantage of the invention is the ability of such a greater height in the front area, so that the amount of surgery can be used to obtain a lordosis that the front side of the intervertebral space is larger than the capacity of the rear side of the intervertebral space.

发明的公开内容本发明是一种椎间空间植入物,其形状做成能以侵害最小或开口最小的外科手术后置地植入。 Disclosure of the Invention The present invention is an intervertebral implant space, its shape can be made against the minimum or minimal surgical opening set after implantation. 该植入物包括含第一部件和第二部件的两个独立部件。 The implant comprises two separate components comprising a first member and a second member. 第一部件和第二部件通过脊柱两侧不同的切口沿在该椎间空间中相交的路径进入该椎间空间。 The first member and the second member into the intervertebral space through the incision along the different sides of the spine intersecting path in the intervertebral space. 为了用植入物增大该椎间空间的扩展,两部件在底面和顶面之间的高度大于其侧向宽度。 In order to expand the use of the implant increases the intervertebral space, the two parts at a height greater than its bottom and top surfaces between the lateral width. 因此能以顶面和底面互相沿侧向隔开的方式引入两部件,而后旋转90度,使顶面位于底面上方,使部件的高度达到最大。 Therefore, the top and bottom surfaces can be laterally spaced from each other along the way to the introduction of a two-part, then rotated 90 degrees, so that the top surface is located above the bottom surface, so that the maximum height of the component.

第一部件和第二部件相交的相邻部分是除去的,使两部件安置在基本上共同的平面内。 Adjacent portions of the first member and the second member is removed intersect, so that the two members disposed in a substantially common plane. 最好是,第一部件包括一个在其中点附近沿侧向通过第一部件的孔道。 Preferably, the first member includes a point near where the lateral bore through the first member. 第二部件在其中点附近有一颈部,该颈部的高度小于第二部件的其它部分。 In the vicinity of the point where the second member having a neck portion, the neck portion is less than the height of the other portion of the second member. 该孔道的尺寸能使第二部件穿过第一部件的孔道然后旋转而使第二部件的颈部安置在第一部件的孔道中。 The pore size of the second member through the tunnel to make the first part of the neck and then rotated and the second member disposed in the bore of the first member.

在第二部件已旋转后,两部件成交叉图形联锁在一起,从而形成本发明的植入物装置。 After the second part has been rotated, the two parts into crossbones interlock together to form an implant device of the present invention. 因此,本发明的植入物装置的优点是,具有相当低的外形轮廓,以便以侵害最小的方式后置地插入,但仍形成一个具有联锁在一起的独立的两部件的总体的植入物装置,从而形成一个单独的基本上刚性的植入物装置,以最大地稳定与该椎间空间相邻的椎骨。 Thus, the advantages of the implant device of the present invention is to have a relatively low profile shape in order to minimize the way home after a violation is inserted, but still in an overall implant having interlock together two independent members means to form a single substantially rigid implant device, in order to maximally stabilize the intervertebral space and adjacent vertebrae.

此外,两部件的形成方式便于两部件在植入后的高度的扩张,特别在两部件的远端处。 In addition, the formation of a two-part approach facilitates a high degree of expansion of the two components after implantation, particularly in the two parts of the distal end. 此种补充的高度的扩张进一步稳定与该椎间空间相邻的椎骨,并对该椎间空间提供脊柱前凸。 The expansion of such highly complementary to further stabilize the intervertebral space between adjacent vertebrae and the intervertebral space to provide lordosis.

具体地说,第一部件的形状最好是有一与底面隔开的顶面,它们彼此相对地枢轴式转动,比如围绕一枢轴转动。 Specifically, the shape of the first member is preferably spaced from a top surface and a bottom surface, pivot relative to each other, for example, about a pivoting. 一个通道穿过该顶部构造和底部构造之间。 A passage through the structure between the top and bottom of the structure. 一个填隙片能够沿该通道通过,当该填隙片进入通道的锥形端部部分时,该填隙片形成第一部件的一个其高度被扩张的远端。 A shims can be moved through the channel, when the shim into the passageway of the tapered end portion, the shim formed of a first member whose height is expanded distal end. 第一部件的远端从而将其高度扩张到外科医师希望的程度,以便对脊柱融合手术提供所要的“脊柱前凸”量。 The distal end of the first part of which will expand to the extent of its height surgeons hope to spinal fusion surgery to provide the desired amount of "lordosis."

同样,第二部件最好由一顶部颚片和一底部颚片形成,两颚片能彼此相对地枢轴式转动,例如围绕一枢轴。 Similarly, the second member is preferably formed by a top jaw and a bottom jaw sheet piece, the two jaw piece can pivot relative to each other, for example about a pivot axis. 在顶部颚片和底部颚片之间通过一个孔,在孔内移动一个楔形件,其移动方式使顶部颚片和底部颚片分开并使第二部件的高度在第二部件的第一远端处增大。 Between the top sheet and the bottom jaw jaw sheet through a hole in the hole to move a wedge member, which moves with the top sheet and the bottom jaw and jaw piece separately height of the second part of the first distal end of the second member Department increases.

两部件本身的插入以及填隙片和楔形件在两部件中的移动以增大其高度都通过小的后切口来完成。 Two component itself is inserted and shims and wedges moving in two parts in order to increase its height through a small incision to complete. 对植入物装置的两部件提供了各种不同的枢轴机构、填隙片和楔形件机构及其它构造变型。 Two components of the implant device to provide a variety of pivot mechanism, shims and wedges agencies and other construction variations.

附图简述图1是有一包含本发明的植入物装置的椎间空间的人体脊椎的侧视图。 BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 is a space containing intervertebral implant device of the present invention is a side view of the human spine.

图2-5是沿图1的线5-5截取的顶视平面图,例示植入本发明植入物装置中涉及的四个基本步骤。 Figure 2-5 is along the line 5-5 in FIG. 1 a top plan view, illustrating the four basic steps of the implant apparatus of the invention relates to an implant.

图6是该植入物装置的第一部件的侧视图,其空腔内部细节用虚线表示。 Figure 6 is a side view of the implant device of the first member, which hollow internal details shown in phantom.

图7是图6中所示的第一部件的顶视平面图。 Figure 7 is a top plan view of the first member shown in Figure 6.

图8是图6中所示的第一部件的近端立视图。 Figure 8 is a proximal end of the first member shown in Fig. 6 elevational view.

图9是图6中所示的第一部件的全截面图,图中示出本发明的一根引导线和填隙片进入第一部件中的通道内以扩张第一部件的邻近其远端的高度。 Figure 9 is a full sectional view of a first member shown in FIG. 6, there is shown a guide wire of the present invention and the shim member into the first channel to the expansion of the first member adjacent its distal end height.

图10是图9中所示的第一部件的在填隙片已全部进入第一部件的通道后的全截面图,第一部件的远端的高度因此已经增大。 Figure 10 is a full sectional view of the first member 9 shown in all of shims into the passage has a first post member, the height of the distal end of the first member and therefore has increased.

图11是本发明的植入物装置的第二部件与用来增大本发明的植入物装置的第二部件的远的第一端的高度的工具的一种形式一起的全截面侧视立面图。 FIG. 11 is a form of the second implant member of the apparatus of the present invention and used to increase the implant device of the present invention, the height of the second member of the first tool distal end along a cross-sectional side view of the whole elevation.

图12是图11中所示的第二部件与用虚线表示的内部细节的顶视平面图。 FIG. 12 is shown in the second part of the internal details of a dotted line top plan view of FIG. 11.

图13是图12中所示的第二部件的近的第二端的视图。 FIG 13 is a second side view of the second member near 12 shown in FIG.

图14是图11中所示的第二部件在一个楔形件已完全前进以增大第二部件的远的第一端的高度之后的全截面图。 FIG 14 is a second member 11 shown in FIG. After having fully advanced to increase the height of the second member of the far end of a first full sectional view of the wedge member.

图15是表示可用来植入本发明的第一部件或第二部件的工具的一种形式的夹钳的顶视图。 FIG. 15 is a top view of a form can be used to implant the first part of the present invention or the second part of the tool clamp.

图16是图6中所示的第一部件的替代实施例的表示一偏置枢轴的侧视立面图。 16 is a side elevational view of an alternative biasing the first pivot member shown in Fig. 6 embodiment.

图17是图16中所示的替代实施例的近端的视图。 16 FIG. 17 is a view of an alternative embodiment shown in the view of the proximal end of the embodiment.

图18是本发明的第一部件的第二替代实施例的近端的视图。 Figure 18 is a second alternative of the present invention, a first member proximal end view of the embodiment.

图19是本发明的植入物装置的第一部件的第三替代实施例与用虚线表示的内部细节的侧视立面图。 Figure 19 is a side elevational view of the embodiment indicated by broken lines the internal details of a third alternative of the first implant member of the apparatus of the embodiment of the present invention.

图20是图19中所示的第三替代实施例的远端的视图。 Figure 20 is a third alternative shown in FIG. 19 view of the distal end of an embodiment.

图21是图19中所示的第三替代实施例在与本发明的植入物装置的第三替代的第一部件一起使用的一个替代的填隙片完全前进后的侧视立面图。 Figure 21 is a side elevational view of an alternative embodiment of the third shims alternative implant of the present invention, an apparatus for use with a first member of a third alternative after fully advanced in embodiment 19 shown in FIG.

图22是本发明的植入物装置的第一部件的第四替代实施例的全截面侧视立面图,表示一根引导线与一个在第四替代的第一部件中前进经过一孔道的填隙片和一近填隙片及扩张枢轴,以使本发明的植入物装置的第四替代的第一部件的近端能够扩张其高度。 FIG 22 is a fourth alternative of the first member of the present invention is an implant device fully cross-sectional side elevational view of the embodiment showing a guidewire and advancing through a bore in a fourth alternative of the first member and a proximal shims and shim expansion near the pivot, so that the implant device of the present invention a first member of a fourth alternative can expand its height.

图23是图22中所示的第一部件的第四替代实施例在将该实施例的近填隙片插入一个近凹部以增大本发明的植入物装置的第四替代的第一部件的近端高度的全截面侧视立面图。 Figure 23 is a first member shown in FIG. 22 in a fourth alternative embodiment of the embodiment of shims inserted near a recess near to increase fourth alternative implant device of the present invention, a first member The proximal end of the whole cross-section height of the side elevation.

图24-27是本发明的植入物装置的第四替代的第一部件的一个扩张的枢轴的截面图和侧视立面图,详细表明该扩张的枢轴的操作中的各个阶段。 Figure 24-27 is a sectional view of an expansion of the pivotal fourth alternative the first part of the implant device of the present invention and a side elevation detail shows that the expansion of the pivot operation at all stages.

图28-30是本发明的植入物装置的替代装置的顶视平面图,表示能够如何在第一部件中的孔道和第二部件中的颈部邻近处提供各种斜面和释放切口,以便于第二部件在第一部件的孔道内转动和便于第二部件相对于第一部件的角度不单纯是垂直角度的取向。 28-30 is a top plan view of an alternative means of implant device of the present invention, showing how to provide a variety of ramps and can release the cut in the first part and the second part of the tunnel adjacent to the neck in order to The second part of the second member to facilitate rotation and angle relative to the first part is not simply a vertical angle of orientation within the bore of the first member.

实现本发明的最佳方式参照附图,各图中相同标号表示相同部件,标号10(图1)指示一个植入物装置,用于在已经从椎间空间S中移去一个椎间盘之后移植到相邻椎骨V之间的椎间空间S中。 The best embodiment of the present invention with reference to the drawings, the same reference numerals in the drawings denote like parts, reference numeral 10 (FIG. 1) indicates an implant device for a disc has been removed from the intervertebral space S after transplant S V adjacent vertebrae intervertebral space between. 第一部件20和第二部件60沿不同的通道被植入,但在椎间空间S内联锁在一起而形成单独的植入物装置10。 20 and a second member 60 along the different channels of the first member is implanted, but within the intervertebral space S interlocked together to form a single implant device 10. 形成的装置10使邻近椎间空间S的椎骨V牢固地稳定,以便将两块椎骨V脊柱融合在一起。 Means 10 formed so that the adjacent vertebrae the intervertebral space S V firmly stable, so that V spinal vertebrae together.

本质上,特别参照图1-图5,来描述植入物装置的基本细节。 Essentially, with particular reference to Figs. 1-5, the implant device described basic details. 植入物装置10包括第一部件20(图2)和第二部件60(图4)。 The implant device 10 comprises a first member 20 (FIG. 2) and the second member 60 (FIG. 4). 第一部件20为沿第一轴线A延伸的细长形。 The first member 20 is elongated along a first axis A extends. 第一部件20最好高度大于宽度(比较图2和图3),从而有一矩形截面。 The first member 20 is preferably a height greater than the width (compare FIGS. 2 and 3), so that has a rectangular cross section. 因此第一部件20能够在其侧面上插入椎间空间中(沿图2的箭头C),而后在椎间空间中转动(沿图3的箭头F),以帮助扩展邻近椎间空间S的两块椎骨V彼此分开。 Therefore, the first member 20 can be inserted in the intervertebral space in its side (along the arrow C 2), and then rotated (in the direction of arrow F 3) is in the intervertebral space, to help expand the two adjacent intervertebral space S vertebrae V apart from each other. 第一部件20还包括从侧面穿过第一部件20的孔道30(图2)。 The first member 20 further includes a first member from the side through the bore 30 (FIG. 2) 20.

第二部件60(图4)是细长的,其外形大体上与第一部件20的外形相似。 The second member 60 (FIG. 4) is elongated, its shape is substantially similar to the shape of the first member 20. 但是,第二部件60包括一个颈部70而不是第一部件20的孔道30。 However, the second member 60 includes a neck portion 70 instead of the first member 20 of the tunnel 30. 第二部件60的截面尺寸与孔道30相似。 30 is similar to the cross-sectional dimension of the second channel member 60. 该尺寸使第二部件60能够沿第二轴线B(沿图4的箭头E的方向)插入第一部件20的孔道30。 The dimensions of the second member 60 can be inserted into the first member bore 30 along a second axis 20 B (the direction of arrow E in FIG. 4). 第二部件60稍后能够以类似于第一部件20转动的方式转动(沿图5的箭头G),使得第二部件60的高度沿垂直方向,并尽可能增大邻近椎间空间S的两椎骨V的间隔。 The second member 60 in a manner similar to later be able to rotate the first member 20 is rotated (in the direction of an arrow G 5), so that the second member 60 of the height in the vertical direction, and increases as the two adjacent intervertebral space S vertebrae V interval. 部件20、60联锁在一起而形成植入物装置10,部件20、60使彼此稳定,并使植入物装置10能够稳定其中植入了装置10的椎间空间。 Interlocking members 20, 60 together to form the implant device 10, 20, 60 so that each stabilizing member, and the implant device 10 can be stably implanted in the intervertebral space in which the apparatus 10.

更具体地说,特别参照图6-图10,来描述按照本发明的一个优选实施例的第一部件的细节。 More specifically, 10 to describe the details of the first member according to a preferred embodiment of the present invention, particularly with reference to Figures 6 embodiment. 第一部件20是一个由顶部构造22和底部构造24形成的基本上刚性的细长构成物,构造22和24可以枢轴式转动地结合在一起,例如用枢轴25。 The first member 20 is constructed of a substantially rigid elongate constituting the top 22 and bottom structure 24 was formed, the structure 22 and 24 can pivot together, e.g., by a pivot 25. 枢轴25可以取许多不同形状来提供允许顶部构造22和底部构造24能够彼此相对地枢轴式转动的基本功能。 Pivot 25 may take many different shapes to provide a structure allowing the top 22 and bottom 24 can be configured to function relative to each other substantially pivotable.

第一部件20从远端26延伸到近端28。 The first member 20 extends from the distal end 26 to the proximal end 28. 能够可以选择地包括一个引导线止动器27与底部构造24一起在远端26处并向上伸出而超过顶部构造22。 It can may optionally include a guide wire stopper 27 together with the lower structure 24 extends to the distal end 26 rather than the top of structure 22.

孔道30沿侧面在第一部件20的顶面和底面之间穿过第一部件20。 30 tunnels along the side between the top and bottom surfaces of the first member 20 through the first member 20. 孔道30包括一个最好基本上与底部34平行的顶部32和延伸在底部34与顶部32之间的侧面36。 Tunnel 30 preferably comprises a substantially parallel top and bottom 32 and 34 extending between the side surfaces 34 and 36 top 32 bottom. 孔道30的尺寸最好与第一部件20本身的外部尺寸相似,但转动90度。 Pore size 30 of the first member 20 is preferably similar to the external dimensions itself, but rotated 90 degrees. 因此孔道30的尺寸允许具有相似于第一部件20的尺寸的第二部件60在椎间空间S内形成本发明的植入物装置10期间(图1-5)从侧面穿过孔道30。 Therefore, the pore size of 30 allows a first member having a size similar to that of the second member 20 of the implant device 60 of the present invention is formed in the intervertebral space during S 10 (FIG. 1-5) from the side through the bore 30.

通道40沿纵向延伸在第一部件20内和顶部构造22和底部构造24之间。 Channel 40 extends longitudinally within in 20 and 22 and the top of the first component is configured between the bottom of the structure 24. 通道40在第一部件的近端28处包括一个入口42。 Channel 40 at the proximal end 28 of the first member includes an inlet 42. 通道40还包括一个最好基本上平行于底面46并与底面隔开的顶面44。 Channel 40 also includes a preferably substantially parallel to the bottom 46 and a top surface and a bottom surface spaced 44. 最好是,通道40从入口42到通道40与孔道30相交的位置具有恒定的截面。 Preferably, the channel 40 and channel 40 30 intersects with a constant cross-section from the inlet to the channel 42. 通道40最好继续越过孔道30并通向第一部件20的远端26。 Channel 40 is preferably continued across the channel 30 and leads to the distal end of the first member 20 26. 但是,通道40在孔道30的远侧上的部分最好逐渐变窄而形成通道40的锥形端部48。 However, 40 of the distal portion of the channel in the channel 30 is preferably formed gradually narrowing the tapered end 48 of the channel 40. 在通道40内直接邻近孔道30处最好设置一个台阶49。 Directly adjacent to the channel 30 in the channel 40 is preferably provided a step 49.

通道40的形状做成可以在其中容放一个填隙片50。 The shape of the channel 40 can be made in accommodating a shim 50. 填隙片50(图9)最好具有大体上填充该通道40(图8)的矩形截面,使得该填隙片不会转动。 Shims 50 (FIG. 9) having a preferably substantially filling the channel 40 (FIG. 8) of rectangular cross-section, so that the shims does not rotate. 填隙片50最好包括一个高度比尾部54小的顶端52。 Shim 50 preferably includes a tail portion 54 smaller than the height of the top 52. 中心通路56最好穿过填隙片50。 The central passageway 56 is preferably through the shim 50. 引导线58能够完全穿过通道40直到止动器27(沿图9的箭头H),然后填隙片50穿线在引导线58上。 The guide wire 58 can pass completely through passageway 40 until the stopper (along arrow H in FIG. 9) 27, 50 and shims 58 threaded on the guide wire. 然后填隙片50能够容易地沿引导线58前进(图9的箭头J)并引入通道40。 Then shims 50 can be easily along the guide wire 58 is advanced (arrow in FIG. 9 J) and introducing passage 40. 当填隙片50到达通道40的锥形端部48时,在一个合适的填隙片推动工具的帮助下,填隙片50使第一部件20的顶部构造22和底部构造24彼此扩张分开(围绕图10的箭头K),而第一部件20的高度在第一部件20的远端26处增大。 When the tapered end shim 50 reaches the channel 40 of 48, in a fit shims pushing tool with the help of shims 50 of the first member of the top 20 and bottom 22 configured structure 24 separated from each other expansion ( around an arrow K 10), while the height of the first member 20 is increased at a distal end 26 of first member 20.

第一部件20的这种远端26高度扩张在许多情况下是需要的,以便对椎间空间S提供脊柱前凸。 The first part of this great expansion of the distal end 26 20 in many cases is needed in order to provide the intervertebral space S lordosis. 具体地说,脊柱前凸是对锥间空间S的取向,那里锥间空间S的前缘的高度大于其后缘的高度。 Specifically, the lordosis is orientation interbody space S, where cone height space between the front edge of S is greater than the height of the trailing edge. 这样的脊柱前凸能够提供不同的程度,取决于医护人员的愿望。 Such lordosis can provide different degrees, depending on the wishes of the medical staff. 利用本发明,填隙片50前进了所希望的一个量而通过第一部件20的通道40,以提供填隙片的一个在医护人员判断中所希望的量。 With the present invention, shims 50 proceeds a desired amount of the first member 20 through the passage 40, to provide a shim in the medical judgment of the desired amount. 部件20能够定做而设计成提供所希望的脊柱前凸或能够在植入期间可以可变地扩张以便调节。 Member 20 can be custom designed to provide the desired lordosis or during implantation can be variably adjusted in order to expand.

特别参照图11-图14,图中描述了第二部件60的优选实施例。 14, FIG. 60 described the preferred embodiment of the second member in particular with reference to FIG 11- FIG. 第二部件60最好有一个与第一部件20相似的总体外形轮廓。 The second member 60 preferably has a first member 20 with similar overall contour. 同时,第二部件60最好分成可枢轴式转动地连接在一起的顶部颚片62和底部颚片64,它们可枢轴式转动地连接在一起,例如在枢轴65处。 Meanwhile, the second member 60 is preferably divided into a pivotable connected together at the top sheet 62 and bottom jaw jaw piece 64, which can pivot connected together, for example at a pivot 65. 如对第一部件20一样,枢轴65能采取各种不同构型。 The same as the first member 20, the pivot 65 can take a variety of different configurations. 第二部件60从第一远端66延伸到第二近端68。 The second member 60 extends from the first distal end of the proximal end 66 to the second 68.

第二部件60包括一个颈部70,该颈部70有两个最好基本上平行的表面72和延伸在颈部70的平行表面72与第二部件60的顶面和底面之间的侧壁74。 The second member 60 includes a neck portion 70, the neck portion 72 and a sidewall 70 extending between the parallel surfaces 72 of the neck 70 and the top and bottom surfaces of the second member 60 is preferably of two substantially parallel surfaces 74. 侧壁74可以垂直于平行表面(如图4中大体上描绘的)或可以是斜面(如图11中所示)。 Parallel to the side walls 74 may be perpendicular to the surface (generally depicted in FIG. 4) or may be beveled (as shown in Figure 11). 平行表面72之间的距离小于第二部件60的顶面和底面之间的距离。 The distance between the parallel surfaces 72 is smaller than the distance between the top and bottom surfaces of the second member 60 between. 平行表面72不需精确平行,但其高度小于第二部件60的顶面和底面的高度是有利的,使得第二部件60的颈部70是一个开口区,然后在将第二部件60转动到使其顶面和底面与第一部件20的顶面和底面垂直对准的取向时能够停留在第一部件的孔道30或其它开口区中(图5)。 Parallel surfaces 72 need not exactly parallel, but the height is less than the height of the top surface and the bottom surface of the second member 60 is advantageous, so that the neck portion 60 of the second member 70 is an open area, then the second member 60 is rotated to when its top surface and the top and bottom surfaces perpendicular to the bottom surface of the first member 20 aligned orientation can stay in the channel 30 or other openings in the area of the first part (Figure 5). 最好是,颈部70安置在第二部件60的远的第一端66和近的第二端68之间的中点附近。 Preferably, the neck portion 70 disposed near the midpoint between the second member 60 away first end 66 and second end 68 near.

第二部件60的两侧面之间的宽度最好相似于颈部70的高度和第一部件20中孔道30的高度,以便在转动(围绕图5中箭头G)前和转动后在孔道30中紧配合。 Preferably the width of side surfaces of the second member 60 similar to that between the first member 70 and the height of the neck 20 of the channel 30 of height, so that the rotation (arrow in FIG. 5 around G) before and after the rotation in the bore 30 tight fit. 第一部件20中的枢轴25、部件20、60的一般稍许的可弯曲性和可能的稍许附加的容隙能够提供允许第二部件60在孔道30内与颈部70一起转动所需的松动。 20, a first pivot member 25 is generally slight, members 20, 60 can be bent and possible slight gap to provide additional capacity to allow the second member 60 within the bore 70 is rotated together with the neck portion 30 required loosening . 最好是,第二部件60能够卡入其最终位置,使得部件20、60牢固地联锁在一起。 Preferably, the second member 60 can snap into its final position, so that the interlocking member 20, 60 securely together.

为了对椎间空间S提供脊柱前凸,第二部件60的形状能够扩张高度,特别在远的第一端66处。 In order to provide the intervertebral space S lordosis, shape of the second member 60 can expand height, particularly in the far end of the first 66. 具体地说,第二部件60包括一个从近的第二端68沿纵向通过的孔80,至少一部分路径向着远的第一端66。 Specifically, the second member 60 includes a hole 68 from near the second end 80 longitudinally through at least part of the path toward the far end of the first 66. 孔60内包括一个销82,销82在其最接近第二部件60的远的第一端66的端部处包括一螺纹端83。 Hole 60 includes a pin 82, the pin 82 includes a threaded end 83 at its distal end portion of the first end 66 closest to the second member 60. 销82的入口端84与螺纹端83对置并最接近第二部件60的近的第二端部68。 The inlet end of the pin 82 and the threaded end 84 and 83 pairs of opposed second closest near end 68 of the second member 60. 能够利用一个具有各种不同构型之一的扳手85(图11)来通过扳手85与销82的入口端84相互作用而转动。 You can use a variety of different configurations with one wrench 85 (FIG. 11) through the wrench 85 and the pin 82 of the inlet end 84 to rotate interactions. 最好是,孔80在邻近近端68处稍小,以防销82在孔80内向着近端68滑动。 Preferably, the holes 80 in the vicinity of the proximal end 68 is slightly smaller, to prevent the pin 82 in the hole 80 within the proximal end of the slide 68.

楔形件86安置在孔80中的锥形孔腔87内。 Wedges 86 placed in the hole 80 in the conical bore 87. 楔形件86最好是圆柱形的,并包括一个通过楔形件的弯的侧面垂直延伸的螺孔,螺孔内安置销82的螺纹端83。 The wedge member 86 is preferably cylindrical and includes a threaded hole through the side of the vertical bending of the wedge member extending pin disposed within the threaded hole 82 of the threaded end 83. 因此,当销82由于工具85的转动而转动(沿图11的箭头L)时,销82的螺纹端83使楔形件86向着第二部件60的远的第一端66行进(沿图14的箭头M)。 Thus, when the pin 82 due to the rotation of the tool 85 is rotated (in the direction of arrow 11 of FIG. L), the threaded end 83 of the pin 82 so that the wedge member 86 toward the first end of the second member 66 travels away 60 (Fig. 14 along the arrow M). 当楔形件86向着远的第一端66行进并通过锥形空腔87时,顶部颚片62和底部颚片64垂直扩展(沿图14的箭头N),增大第二部件60的高度。 When the wedge 86 toward the first end 66 travels far and through the conical cavity 87, the top sheet 62 and bottom jaw jaw piece 64 vertical expansion (Fig. 14 along arrow N), increasing the height of the second member 60.

虽然图示的第一部件20和第二部件60具有唯一的垂直扩张部件20、60的顶部和底部的系统,但可以注意到,这些系统仅仅是部件20、60的垂直高度增大系统的一个当前最优选的实施例。 Although the first member and the second member 20 illustrated system 60 has a unique vertical expansion members 20, 60 of the top and bottom, but it may be noted that these systems are merely increasing the height of the vertical members 20, 60 of a system the most preferred embodiment. 事实上,可以利用各种不同的系统来增大植入后部件20、60的垂直高度。 In fact, you can use a variety of systems components 20, 60 of the vertical height increases after implantation.

最优选的是,部件20、60具有的顶面和底面之间的高度近似地两倍于部件20、60的两侧面之间的宽度。 Most preferably, the height of the parts 20, 60 having top and bottom surfaces between approximately twice the width of the side surfaces 20, 60 between components. 能够利用一把夹钳90(图15)来将部件20、60合适地安置在椎间空间S内(图1)。 Can use a clamp 90 (FIG. 15) to the members 20, 60 suitably disposed in the intervertebral space S (Fig. 1). 夹钳90通常具有钳指92,钳指具有尖端93,其宽度近似于部件20的侧面宽度的一半。 Clamp means 90 typically has a clamp 92, clamp means having a tip 93, a side member 20 having a width of approximately half the width. 以此种方式,可以用夹钳90的钳指92的尖端93夹住部件20、60的侧面,而部件20、60能够通过一个套管前进,该套管的直径近似于部件20、60的顶面和底面之间的高度。 In this manner, the clamp 90 can clamp means 20, 60 of the side edge 93 of the clamp member 92, and a sleeve member 20, 60 through the forward, the sleeve member 20, 60 of a diameter approximately height between the top and bottom surfaces. 夹钳90可以包括一枢轴94,在夹钳90的端部处具有与钳指92对置的把手96,以便可以释放地夹住部件20、60。 Clamp 90 may include a pivot 94, has 92 pairs of clamp means 96 at the opposed handle end portion of the clamp 90 so that members 20, 60 can be releasably clamped.

或者是,部件20、60可以在其近端28、68处通过部件20、60的顶面、底面和两侧面内的适当的接合机构来夹住,以便通过部件20、60的套管不需要因夹钳90或其它安置工具而增大截面直径。 Alternatively, the components 20, 60 can be clamped at its proximal end the top, bottom and right sides of the plane of the engagement mechanism at the through parts 20, 60 28, 68, 20, 60 in order to adopt parts of the casing is not required because placement tool clamp 90 or other cross-sectional diameter increases.

特别参照图16和图17,图中描绘另一种偏置枢轴102的细节。 With particular reference to FIG. 16 and FIG. 17, the details of another offset pivot 102 depicted in FIG. 这样一种偏置枢轴102示出在第一替代的第一部件100上。 Such a biased pivot 102 shown in the first alternative of the first member 100. 但是,偏置枢轴102同样可以安置在第二部件上,例如第二部件60的一种改型上(图11-图14)。 However, the offset pivot 102 can also be arranged on the second member, e.g., a modification of the second member 60 (FIGS. 11 to 14). 偏置枢轴102有利地允许单独一根轴销穿过其所有枢页(图17)。 Offset pivot 102 advantageously allows a single axis pivot pin passing through all its pages (Figure 17). 因此偏置枢轴102不需要通道40(图8)或孔80(图13)的对置两侧上的两个部分轴销。 Therefore biased pivot 102 need not channel 40 (FIG. 8) or holes 80 (FIG. 13) opposite the two parts on both sides of the pivot pin. 在其它方面,图16和17的替换的第一部件100与本发明的植入物装置10的优选实施例的第一部件20相似。 In other aspects, the replacement of the first member 100 of FIG. 16 and 17 and preferably the implant device 10 of the present invention, a first member 20 similar to the example of embodiment.

图18表示第二替换的第一部件110,其特点是一个分叉枢轴112。 Figure 18 shows a second alternative of the first member 110, which is characterized by a pivot fork 112. 该第二替换的第一部件110上的分叉枢轴112大致地与优选实施例的第一部件20的枢轴25相似(图8)。 A first pivot member pivotally bifurcated first member 110 on the second alternative of the preferred embodiment with substantially 112 20 Example 25 is similar (Figure 8). 但是,叠合的枢页将分叉枢轴112的轴销安置在稍许不同的位置上。 However, the page will be superimposed pivoting fork pivot axis 112 of the pin placed in slightly different positions. 图18的第二替换的第一部件110和分叉枢轴112例示许多不同的枢轴构型之一,其中本发明的植入物装置10的部件20、60能够有效地使部件20、60的顶部和底部相对移动。 The first part of the second alternative 110 18 112 cases and fork pivot pivot illustrates one of many different configurations, wherein the implant device of the present invention, parts 20, 60 10, 20, 60 can be effectively member The top and bottom of the relative movement.

虽然制造部件20、60的材料通常是某种形式的外科手术级的生物兼容的不锈钢或其它材料,但可以考虑,制造部件20、60的材料可以是碳氢聚合物或其它塑性材料的一种形式,或具有显著的可弯曲特性的金属材料。 Although material section 20, 60 is usually some form of surgical grade stainless steel or other biocompatible material, but can be considered material member 20, 60 may be a hydrocarbon polymer or other plastic material form, or with significant bendable characteristic metallic material. 如果部件20、60用此类材料制成或能够加工成在部件20、60的顶部和底部之间具有足够薄的连接,那么本发明的各种实施例的枢轴25、102、112可以用部件20、60的只是足够地相对弯曲的顶部和底部来代替,以允许部件20、60的远端26、66处的高度产生扩张,从而能够向锥间空间S(图1)提供适当的脊柱前凸量。 If the parts 20, 60, or use of such material can be processed into between the top and bottom parts 20, 60 is connected with a sufficiently thin, then pivot the various embodiments of the present invention can be used 25,102,112 The member 20, 60 is sufficiently curved opposing top and bottom instead, produce a high degree of expansion to allow the distal end member 20, 60 at 26,66, thereby providing the proper spinal interbody space S (FIG. 1) lordosis amount.

特别参照图19-图21,图中描述了第三替换的第一部件。 21, FIG third member is described first with reference to FIG. 19- alternative particularly FIG. 该第三替换的第一部件120的特点是一种与第一替换的第一部件100(图16)的偏置枢轴102相似的偏置枢轴122。 Features of the first member 120 of the third alternative is a first alternative of the first member 100 (FIG. 16) similar to bias the pivot 102 bias the pivot 122. 第三替换的第一部件120额外包括波浪形的叠合锥形表面124作为其邻近远端的顶部和底部构造部分。 The third alternative comprises first wave-shaped member 120 additional superposed conical surface 124 configured as the top and bottom portions adjacent the distal end. 这些波浪形的叠合的锥形表面124能够由于第一替换的填隙片126的沿轴向前进而扩展分开像整个部件120一样宽,填隙片126最好是圆柱形的。 These undulations superposed tapered surface 124 can be due to the axial direction of the first alternative shim 126 extend forward and separated as wide as the entire member 120, shim 126 is preferably cylindrical. 当第一替换的填隙片126前进时(沿图19的箭头P),它通过能够对锥间空间S(图1)提供的脊柱前凸的不同阶段所对应的一系列阶梯。 When the first alternative is advanced shims 126 (FIG. 19 along arrow P), capable of through lordotic interbody space S (FIG. 1) provided in a range corresponding to the different stages of the ladder.

因为锥形表面124是波浪形的,所以提供了可以安置第一替换填隙片126的一系列位置。 Since the tapered surface 124 is undulating, it may be arranged to provide a first position 126 to replace a series of shims. 因此能够对锥间空间S(图1)提供对应于各种不同程度的脊柱前凸的不同程度的高度的调整。 It is possible for interbody space S (Fig. 1) corresponding to various degrees of lordosis height adjustment to varying degrees. 第一替换的填隙片126可以通过用任何合适形状的推杆穿过入口通道126推动而前进,或者可以利用一个螺纹销前进与优选实施例的楔形件86沿第二部件60的销82前进相似。 The wedge member 86 along a second pin member of the first alternative shims 126 can be of any suitable shape by passing through the inlet passage 126 of the push rod and push forward or advance can be used with a threaded pin 60 of the preferred embodiment of the forward 82 similar.

因为锥形表面124叠合,所以能够在第三替换的第一部件120的远端处提供更大的高度增大量(见图20)。 Since the tapered surface 124 overlap, it is possible to provide a greater increase in the height of the first member 120 at the distal end of a third alternative of a large number (see Figure 20). 第三替换的第一部件120的这种高度的变化系统可以以由于外形相当低的通道128而产生的相当直接的方式适合一个具有颈部而非孔道的替换的第二部件,该通道128可以通过一颈部而并不牺牲这样一个替换的第二部件的颈部的强度。 The first member of this third alternative variation in the height of the system 120 may be relatively straightforward manner due to the shape of the passage 128 relatively low generated for a second member having a neck portion rather than the alternative channel, the channel 128 may by a neck without sacrificing strength of such a replacement second part of the neck. 因此,该高度变化系统仅为方便而例示于第一部件的上下文中,但可以同样好地包括在第二部件中。 Therefore, the height of the changes to the system for convenience only and is illustrated in the context of the first part, but it can equally well be included in the second part.

特别参照图22-图27,图中描绘了第四替换的第一部件的细节。 With particular reference to FIG. 22- 27, depicted is a detail of the first member of the fourth replacement. 第四替换的第一部件130的形状做成既可在其近端也可在其远端进行高度的调整。 A fourth alternative shape of the first member 130 is formed at its proximal end can also be adjusted in the height of its distal end. 具体地说,第四替换的第一部件130的顶部和底部最好用膨胀枢轴132结合在一起。 Specifically, the top and bottom of the first member 130 is preferably a fourth alternative expansion pivot 132 together.

图24-图27中详细地示出膨胀枢轴的功用。 Figure 24- Figure 27 is shown in detail in the expansion the pivot function. 膨胀枢轴132包括两个在通过膨胀第四替换的第一部件130延伸的纵向通道对置两侧上的两个独立的轴销134。 Expansion pivot 132 comprises two longitudinal channels through the replacement of the first member 130 extends fourth expansion of two independent axes on opposite sides of the pin 134. 轴销134安置在槽136中。 Axle pin 134 positioned in the slot 136. 因此,膨胀枢轴132允许转动和垂直膨胀两者(沿图25和图26中的箭头R)而仍然将第四替换的第一部件130的顶部和底部保持在一起。 Thus, the pivot 132 allows the expansion of both the expansion (25 and 26 along the arrow R) is rotated and vertically while still holding together the top and bottom of the first member 130 of the fourth replacement.

穿过第四替换的第一部件的纵向通道包括一个邻近第四替换的第一部件130的近端的近凹部140。 Alternatively longitudinal passage through the fourth member includes a first recessed portion adjacent the first member near the proximal end of the fourth replacement 130 140. 近填隙片142能够沿一引导线前进,其方式类似于优选实施例的第一部件20的填隙片50的前进方式。 Near shims 142 can move forward along a guide wire in a manner similar to the way forward, the first shim members 20 of the preferred embodiment 50. 近填隙片142的形状最好与近凹部140的形状匹配。 Shape near shim 142 preferably matches the shape of the concave portion 140 near. 因此,当近填隙片142进入通道时(沿图22的箭头Q),近填隙片142使第四替换的第一部件130的顶部和底部彼此离开,直到近填隙片142安置在近凹部140中。 Thus, when the shim 142 into the channel near the time (in the direction of an arrow Q 22), 142 near shim fourth alternative of the first member 130 of the top and bottom away from each other until nearly shims 142 disposed near recess 140.

作为提供近凹部140的替代方法,近填隙片142可以只具有锥形(示于图22),而近填隙片142的锥形表面与第四替换的第一部件130的通路上下表面之间的摩擦可以使近填隙片142留在已前进的位置中,除非对近填隙片142施加了特殊的力。 As an alternative to providing near recesses 140, near shims 142 may only have a tapered (shown in FIG. 22), and the upper and lower surfaces of the first channel member near the tapered surface 142 and the fourth shim 130 is replaced friction between the shims can make nearly 142 have been left in place in advance, unless shims nearly 142 special force is applied.

如图22中所示,一个与优选实施例的填隙片50相似的填隙片首先沿引导线前进而进入第四替换的第一部件130中的通道的锥形端部内。 The tapered end portion of the first member shown in Figure 22, a shim 50 of the preferred embodiment is similar to the first shim along the guide wire advances into the fourth alternative internal passage 130. 然后近填隙片142前进进入通路。 Then near shims 142 advanced into the passageway. 因此,第四替换的第一部件130在邻近其远端和近端两处遇到高度变化。 Thus, the first member 130 of the fourth replacement height variation encountered in two adjacent its distal end and a proximal end. 近填隙片142同样能用于与扩展的枢轴132一起装入第二部件60的近的第二端68,以给予第二部件60的近端68高度稳定性。 Near shims 142 can also be used together with the expansion of the pivot mount 132 of the second member 68 near second end 60, a proximal end 68 to impart a high degree of stability of the second member 60.

图28表示第五可替换的第一部件150,该部件独特地包括成斜角的孔道侧面152。 Figure 28 shows a fifth alternative of the first member 150, the member including a uniquely angled bore 152 side. 这些成斜角的孔道侧面152允许第二可替换的第二部件155以非垂直方向穿过孔道。 These channels beveled side surface 152 allows the second alternative of the second member 155 in a non-vertical direction through the tunnel. 具体地说,第二部件155相对于第五替换的第一部件150的角度可以是小于90度或大于90度(图28中箭头X)而不必刚巧是90度。 Specifically, the second member 155 with respect to the angle of the first member 150 of the fifth alternative may be less than 90 degrees or greater than 90 degrees (Fig. 28 arrow X) rather happens to be 90 degrees. 图28中示出的角度X为约60度,但可以减小到45度或更小而仍允许第二部件155穿过第五变换的第一部件150而不会被成斜角的孔道侧面152阻塞。 Side channels 28 shown in FIG angle X is about 60 degrees, but can be reduced to 45 degrees or less and still allow the second member 155 through the first member 150 without being converted fifth beveled 152 blocked. 成斜角的孔道侧面152与第五替换的第一部件150的长轴成约45度角而不是直角。 Beveled side channel 152 and the long axis of the first member 150 Fifth replace about 45 degrees rather than a right. 但是,成斜角的孔道侧面152的角度和第二部件155相对于第五替换的第一部件150的角度X可以增大或减小,取决于医护人员对植入物装置10的要求。 However, the angle of beveled side surface 152 of the bore and the second member 155 relative to the first member 150 of the fifth alternative angle X can be increased or decreased, depending on the medical requirements for the implant device 10.

第二替换的第二部件155最好包括一释放斜面156(图28),斜面156使第二替换的第二部件155中的颈部的侧壁能够在第二替换的第二部件155已转入其最终位置后与第一替换的第一部件150的一个侧面接触。 A second sidewall of the second member 155 preferably includes a replacement releasing ramp 156 (FIG. 28), the second inclined surface 156 of the second member 155 in the replacement of the neck can be transferred in the second member 155 has a second alternative contact with a first side of the first member 150 after replacement into its final position. 释放斜面156从而使第二替换的第二部件155和第五替换的第一部件150能够以完全联锁的方式彼此更完全地稳定,使得植入物装置10按要求完全稳定锥间空间S(图1)。 Release bevel 156 so that the second alternative 150 can be fully interlocked stable manner more fully with each other and the first part of the second member 155 fifth replacement, so that the implant device according to claim 10 fully stabilized interbody space S ( Figure 1).

图29中示出第六替换的第一部件160,包括在部件160的侧面中紧邻孔道的释放切口162。 Figure 29 shows the first member 160 of the sixth replacement, including adjacent channels in the release notch 160 of the side member 162. 释放切口162是图28实施例的释放斜面156的替换。 Release beveled notch 162 is released embodiment of Figure 28 replaces 156. 具体地说,图29例示或者是释放斜面156可以如何设置在第二替换的第二部件155上,或者是释放切口162可以如何设置在第六替换的第一部件160中,使得能够完全转动第三替换的第二部件164而不需要第二替换的第二部件155的释放斜面156。 Specifically, FIG. 29 illustrates the release ramps 156 may or how to set up on the second member 155 of the second alternative, or how the release notch 162 of the first member 160 may be provided in a sixth alternative, can be fully rotated so that the first release member second inclined surface 156 of the second member 164 without the need to replace the three second alternative 155. 当然也可以采用释放斜面156和释放切口162的组合,使得第一部件和第二部件的紧靠的表面可以以能为整个植入物装置10提供稳定性的方式啮合在一起。 Of course, a combination of ramps 156 may be employed to release and release of the cut 162, so that the abutting surfaces of the first member and the second member may be able to provide stability for the entire apparatus 10 engaging the implant together.

图30中示出与第五替换的第一部件150一起的第四替换的第二部件170。 The second member 30 is shown in Fig first member 150 together with the fifth alternative fourth alternative 170. 图30中示出的植入物装置具有第一替换的第一部件150的截面图,并清楚例示第四替换的第二部件170能够以不是垂直的角度X(图28)通过第五替换的第一部件150中的孔道而配合,并围绕箭头T旋转而到达最终位置如图28中所示。 Figure 30 shows an implant device having a first alternative sectional view of a first member 150, and clearly shows the fourth embodiment of the second member 170 can not replace the vertical angle X (FIG. 28) via a fifth alternative The first member 150 and mating bore and the rotation around the arrow T 28 reaches the final position shown in FIG.

从图30可以看出,对于第四替换的第二部件170穿过第五替换的第一部件150中的孔道,并非严格地需要所有斜角孔道侧面152。 As can be seen from FIG. 30, a fourth alternative to the second member 170 through the first member 150 in the fifth alternative channels, it is not strictly necessary for all sides of the bevel 152 channels. 通过提供沿两个方向的斜角孔道侧面152,第五替换的第一部件150成为可逆的。 By providing channels in both directions along the angled side 152, a first member 150 becomes a fifth alternative reversible. 但是,并非绝对必需包括两个斜角孔道侧面152。 However, it is not absolutely necessary to include two angled side surfaces 152 channels. 相反,在孔道的每一侧面上可以只提供一个斜角孔道侧面152而可以省去其它斜角孔道侧面152。 In contrast, on each side of the tunnel may be provided only one side surface of bore 152 may be omitted bevel other diagonal bore 152 side. 特别是,如图30中所示,可以除去其上包括标号的斜角孔道侧面152而第四替换的第二部件170仍然能够成功地穿过第五替换的第一部件150中的孔道。 In particular, as shown in FIG. 30, which can be removed on the angled side bore 152 and the second label comprises a fourth member 170 can still be successfully replaced through the bore of the first member 150 in the fifth alternative.

在一些颈部侧壁上可以提供类似于释放斜面156(图28)的选择的释放斜面172,但并非所有颈部侧壁上都需要。 On the side wall of the neck can provide a number of similar release ramps 156 (FIG. 28) of the selected release ramps 172, but not all need neck sidewall. 选择的释放斜面172在围绕箭头T旋转后将停靠第一部件150的相邻侧面并在部件150、170之间提供增强的稳定性。 Selected release ramps 172 after rotation in the arrow T around the adjacent sides of the first stop member 150 and between the members 150, 170 to provide enhanced stability.

本公开提供本发明的一个优选实施例和实施本发发明的最佳方式。 The disclosure of the invention provides a preferred embodiment of the present invention and the best mode of the invention. 以此种方式这样描述本发明后,应当清楚,对该优选实施例可以进行各种不同的修改而并不偏离本公开的范围和精神。 After this manner thus described the present invention, it should be clear that the preferred embodiment that various modifications can be made without departing from the spirit and scope of this disclosure. 例如,虽然该实施例中描述的第一部件20和第二部件60是可以扩张的,但本发明的一种简化的变化方案并不需要此种可扩张能力。 For example, although the first member described in the embodiment 20 and the second member 60 can be expanded, but the present invention is a simplified variation does not require such an expandable capacity. 当各种构造识别为一种完成一功能的机构时,该识别预定包括能完成所列举的功能的所有构造。 When a variety of configurations identified as a function of the agency is completed, the tag includes all construction scheduled to complete the functions enumerated.

商业用途本发明的商业用途是提供一种用于椎间空间的植入物,该植入物能够从后部植入而仍然提供一种基本上刚性的植入物装置,用于扩张和稳定与该椎间空间相邻的椎骨。 Commercial use for commercial purposes of the present invention is to provide an implant for the intervertebral space, the implant can be implanted from the rear while still providing a substantially rigid implant device for expansion and stabilization the intervertebral space between adjacent vertebrae.

本发明的另一目的是提供一种具有外形轮廓尽可能小的独立部件的植入物装置,因而能够以侵害最小的外科手术完成后移植。 Another object of the present invention is to provide an implant device contour as a separate component having small, it is possible to order a minimum violation after transplant surgery is completed.

本发明的另一目的是提供一种用于椎间空间的植入物装置,该装置最初以独立的部件进入椎间空间,随后联锁在一起。 Another object of the present invention is to provide an implant device for intervertebral space, the apparatus initially separate components into the intervertebral space, and then interlocked together.

本发明的另一目的是提供一种椎间空间植入物装置,该装置能调整高度,以使椎间空间的总体积尽可能大,并允许在椎间空间的不同部分内选择的高度的调整,来提供一种具有最大灵活性的尽可能精确地安置邻近该椎间空间的椎骨。 Another object of the present invention is to provide an intervertebral space for an implant device which can adjust the height, so that the total volume of the intervertebral space as large as possible, and allow the height at different portions of the selected intervertebral space adjusted to provide a maximum of flexibility are precisely positioned adjacent to the intervertebral space vertebrae as possible.

本发明的另一目的是提供一种植入物装置,该装置能够安置在一个椎间空间中而损伤敏感的周围组织的风险很小。 Another object of the present invention is to provide an implant device that can be placed in a risk of damage to the intervertebral space and little sensitive to the surrounding tissue.

本发明的显示其商业用途的其它目的,在仔细阅读所包括的详细描述、附图和权利要求书后,将非常清楚。 Other objects of the present invention display their commercial use, carefully read the detailed description included, drawings and following claims the book, will be very clear.

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27 Oct 2004C06Publication
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2 Jan 2008C14Granted
13 Jun 2012C17Expiry