CN101516284A - 用于非刚性骨板的端口结构 - Google Patents

用于非刚性骨板的端口结构 Download PDF

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CN101516284A
CN101516284A CNA2007800349010A CN200780034901A CN101516284A CN 101516284 A CN101516284 A CN 101516284A CN A2007800349010 A CNA2007800349010 A CN A2007800349010A CN 200780034901 A CN200780034901 A CN 200780034901A CN 101516284 A CN101516284 A CN 101516284A
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plate
main body
fixation system
port
proximal
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J·M·梅
N·欧
W·康潘尼奥尼
M·V·韦斯特
S·E·怀特
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Warsaw Orthopedic Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7059Cortical plates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8042Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being a cover over the screw head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8047Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8695Washers

Abstract

提供一种整形外科板和用于该板的端口结构。板(16,30,130,230,330,430)可以是非刚性的并且包括用于容纳锚(18)或锚保持装置(20,50,50′,450)的至少一个孔(34,35,434,435,436)。所述至少一个孔(34,35,434,435,436)可以包括刚性端口结构(44,45,132,133,232,233,332,333,410),当所述锚(18)或锚保持装置(20,50,50′,450)接合在板上时该刚性端口结构(44,45,132,133,232,233,332,333,410)防止或抵抗所述板(16,30,130,230,330,430)的变形。

Description

用于非刚性骨板的端口结构
背景技术
对于脊骨损伤的治疗包括在稳定脊骨时使用细长刚性板。板固定的设计可以允许单皮层或双皮层的内在稳定植入。同样已经发现在创伤、退化、肿瘤或传染性过程中稳定上或下颈椎、胸椎、腰椎和/或骶椎骨时所述板可以是有用的。此外,这些板提供了附加益处,即允许具有即时稳定性的同时的神经减压。
在多年的脊骨板固定系统发展期间,已经意识到存在各种需求。例如,板应该提供稳定性以控制各椎骨运动节段在六个自由度上的运动且承受脊骨的轴向负载。板也应该能够维持在材料的疲劳极限之下的应力水平且同时也能够具有小到能够减小其沿脊骨突入到邻近组织内突起的厚度。用来将板连接到椎骨的锚不应该随时间松动或者从板上退出。在最近的二十年中,已经发展出了许多脊骨板固定系统,这些系统解决了针对脊骨稳定性的一些需求和需要。示例包括在美国专利No.6,152,927和美国专利公开No.2004/0215195中公开的示例,其全部内容均并入本文以供参考。
用于提供非刚性稳定结构的板是有利的,因为该板与刚性制造的板相比可以具有更低的模数。非刚性稳定结构也可以由非金属材料制成并且具有理想的成像特征,因为某些金属可以产生成像的人为假象并且散射,而这阻碍了当使用经由X射线、CAT扫描或MRI技术的常规成像时对于骨生长的探测。然而,非刚性板应该也适用于允许骨锚和骨之间的固定接合从而沿脊柱固定板。当接合到板上时通过使骨锚穿过板孔或通过骨锚或任意锚保持装置使板变形从而安装的过程中可能损坏非刚性板。此外,在与板接合后,骨锚和锚保持装置可以易于松动或退出。
发明内容
本发明提供新颖的整形外科板和用于该板的端口结构。该板可以被制成带有至少一个孔的柔性或非刚性主体,其中所述至少一个孔用于容纳锚或锚保持装置。所述至少一个孔可以包括更大的刚性或刚性端口结构从而当所述至少一个锚或锚保持装置被接合到其上时防止或抵抗板的变形。
在另一个实施例中,板主体包括多个孔以容纳锚和/或锚保持装置。所述多个孔被装内衬、成形或以其他方式包括刚性端口结构从而为所述多个孔的至少一部分提供刚性接触部分以使得锚和/或保持装置接合到板上。刚性端口结构可以包括位于所述多个孔的相应孔内的多个端口元件。刚性端口结构也可以包括桥接或连结元件,该元件与所述多个端口元件互连,这样单一端口结构可以接合到板从而装衬(line)、限定或形成所述多个孔中的至少两个。桥接元件可以具有插座以接收位于所述至少两个板孔之间的保持装置。刚性端口结构可以沿板主体的上或近端表面、板主体的下或远端表面接合,或者在板主体的近端表面和远端表面之间延伸。
然而,可以想到,该端口结构可以被配置成被定位在板主体内的单一孔内。在进一步的实施例中,刚性端口结构包括端凸缘,该端凸缘可以向外偏转或变形从而将端口结构接合到板。在另一个实施例中,刚性端口结构包括远端、近端向外延伸的凸缘以及在所述凸缘之间的主体,该主体装衬有板的相应孔且板在所述凸缘之间延伸。
与附图一起考虑本发明的下述说明可以明显认识到本发明的许多目标和优点。
附图说明
图1A和图1B分别是带有附连到其上的板固定系统的脊柱节段的示意性侧面图和平面图。
图2是图1中的板固定系统的一个板实施例的顶部透视图。
图3是图1中的板固定系统的另一个板实施例的顶部透视图。
图4是图1中的板固定系统的另一个板实施例的底部透视图。
图5是图4中板的刚性端口结构的透视图。
图6是图4中板的顶部透视图。
图7是图1中的板固定系统的另一个板实施例的底部透视图。
图8是在附连到板之前图7中板的刚性端口结构的顶部透视图。
图9是包括图1的板固定系统的另一个板实施例的顶部透视图。
图10是图9中板的刚性端口结构以及在该端口结构中的锚的截面图。
具体实施方式
为了更好地理解本发明的原理,现将参考在附图中示出的实施例或示例,并且使用特定语言来描述相同特征。然而,应该理解并不因此试图限制本发明的范围。对于本发明涉及领域中的技术人员而言,可以想到并且实现所述实施例中的任何替换和进一步改进以及在此描述的本发明的远离的任意进一步应用。
在图1A中示出了脊柱节段10的简图,该脊柱节段10包括沿脊柱轴线12延伸的多个椎骨V。椎骨V可以包括脊骨中的骶骨、腰椎、胸椎和颈椎区域中的任意一个或其组合。相邻椎骨V可以被盘空间D隔开,并且一个或多个盘空间D可以包括其间的一个或多个植入物I。植入物I可以是消融装置、骨移植件、人工盘植入物或其他适合的间隔装置。
图1A和图1B示出了沿椎骨V固定的板固定系统14。板固定系统14可以包括一个或多个板16、将所述板固定在一个或多个椎骨V上的锚18以及防止锚18从板16上退出的一个或多个可选保持装置20。板16包括下或远端表面22以及相对的上或近端表面24,其中所述下或远端表面22可被定位于沿着椎骨V或邻近椎骨V。一个或多个孔被设置在远端表面22和近端表面24之间从而容纳锚18和/或保持装置20。
可以沿脊柱的前表面、前斜表面、侧表面、后侧表面或后表面中的任意一个或其结合来应用板固定系统14。板固定系统14可以被接合到相应椎骨V的前主体结构或者被接合到椎骨V的后部元件上,例如蒂或神经突。此外,板固定系统可以包括多个板,所述多个板沿相同或不同椎骨和椎骨高度使用并且在到达椎骨高度的相同或不同通路中。
图2示出了包括板固定系统14的骨板30的一个实施例。板30包括细长主体32,该细长主体32在其上每端具有至少一个孔34、35,所述至少一个孔34、35在远端表面36和近端表面37之间延伸并且在远端表面36和近端表面37处开口。主体32进一步在第一端38和第二端40之间延伸。板30在端38、40之间的长度可以为沿至少两个椎骨延伸。进一步可以想到,该长度可以为沿三个、四个或五个或更多的椎骨延伸。
主体32可以由例如聚合物的第一材料组成,以便其是非刚性的。这个非刚性结构进一步限定了每个孔34、35。孔34、35可以均包括或选择性地包括刚性插入件,从而在相应孔34、35内提供端口结构44、45,以使端口结构具有比板30的主体32更大的刚性。因此,位于孔34、35内的锚至少部分地接触相应端口结构44、45并且抵抗或防止主体32绕孔34、35的变形。
端口结构44可以包括限定凹进或碗状形状的近端部分44a以及形成圆柱形状的远端部分44b,该圆柱形状在远端和近端方向内是直线的。远端部分44b在板30的远端表面36处开口,并且近端部分44a从远端部分44b向近端延伸到近端边缘44c。类似地,端口结构45可以包括限定凹进或碗状形状的近端部分45a以及形成圆柱形状的远端部分45b。远端部分45b在板30的远端表面36处开口,并且近端部分45a从远端部分45b向近端延伸到近端边缘45c。端口结构44、45可以是圆形形状或者细长的以形成槽从而允许沿其在各位置处放置锚。端口结构44、45可以被配置成接合锚从而当锚位于端口结构内时防止锚的转动,或者当锚被置于或位于端口结构内时可以允许锚转动。
边缘44c、45c与板30的近端表面37内的近端凹进表面46、47连通并相邻。近端凹进表面46、47可以有助于在所需通路内将锚导入相应孔34、35中且同时最小化在第一端38和第二端40处的组织收缩。锚18的头部下侧可以以凹凸关系被置于或位于接触近端部分44a、45a。当锚被收紧以接触近端部分44a、45a时,通过与相应端口结构44、45的刚性分界面可以抵抗或防止板相对于锚的变形和拉动。此外,远端部分44b、45b可以提供关于孔的刚性分界面,即当锚相对于板转动时该锚接触孔的分界面,从而抵抗主体32关于相应孔34、35的变形。
孔34、35贯通所述板这样至少一个锚可被置成从中贯穿从而接合至少一个椎骨V。在所述实施例中,一对孔34被放置成在纵向轴线L的相对两侧上并排布置从而容纳两个锚以接合底层椎骨,并且板30的另一端包括一对孔35,这对孔35被类似地放置成容纳锚以接合另一个椎骨。另一个实施例提出了另一种孔布置,即在板的各端处包括三个、四个或五个或更多孔。例如,孔34可以轴向对齐;包括一个轴向对齐的孔和另一个轴向偏移的孔;布置成包括三角、菱形、正方形、圆形或不规则式样的孔式样。
如图2所示,板也可以被划分为沿其外侧边缘具有曲折外形的椎骨高度或结点。其他实施例提出,板包括直线边缘,或者递减以形成梯形或三角形形状的边缘。相邻边缘和表面之间的过渡可以是平滑的且呈圆角的从而减少或防止刺激与其接触的组织。板可以具有容纳多个侧锚的宽度或更小宽度从而减少其轮廓并且为每个椎骨提供单一的孔。在又一实施例中,远端表面36可以沿和/或横于纵向轴线L凹入地弯曲从而沿椎骨表面适配。其他实施例提出了,板30包括沿和/或横于纵向轴线L外凸地弯曲的远端表面36。近端表面37可以被配置成平行于远端表面36从而提供均一厚度,或者不平行于远端表面36从而沿板30的宽度和/或长度提供变化的板厚度。远端表面36可以具有网纹轮廓、脊、肋、凸缘或其他结构来增强或提供与接触了远端表面36的相邻多骨组织的接合。主体32在椎骨V之间的部分可以包括窗口以有利于观察盘空间,或者包括从远端表面36延伸出的构造,该构造可位于盘空间内从而支撑相邻椎骨并且/或者承载移植或消融活性材料。
板30的主体32可以主要由可透过射线的材料制成,例如聚合物基树脂。在一个实施例中,主体32基本由聚醚醚酮(PEEK)高温热塑性塑料制成,该热塑性塑料可商业获得自英国Invibio Biomaterial Solutions of Lancashire的PEEK-OPTIMA商标名下的产品。使用这种材料,改进了与板30相关联的多骨结构的常规成像,例如使用X射线、计算机断层(CAT)扫描或核磁共振成像(MRI),这是因为与使用金属植入物相比消除了成像的人为假象以及散射。同样,例如PEEK等的聚合物将弯曲、折曲和弯转到有限限度。通过允许更大的相对运动并且避免应力遮挡,这个柔软性可以被用于在断裂骨主体或被消融椎骨主体之间提供更好的治愈/消融。板31可以进一步包括一个或多个骨生长元件或消融改进元素,例如骨、骨成型蛋白质(BMP)、脱钙骨基质(DBM)、LIM矿化蛋白质(LMP)、生骨膏等等。
板实施例也可以具有用于将锚保持在孔34、35中以防止锚相对于板以及锚所接合的骨结构退出或松动的装置20。图1示出了保持装置50的一个实施例,该保持装置50包括紧固件52和从紧固件52向外延伸出的保持构件54。紧固件52可以接合孔34之间的板主体32。在板主体32的孔35之间提供第二保持装置50′。在这种配置中,单一的保持装置可以被置于两个孔34或35之间并且被构造成锁定或保持位于孔34或35内的锚。例如,紧固件52可以是接合板主体32内的螺纹的机械螺钉,或者可以是当在板主体32内前进时切入板主体32中的自攻螺钉。其他实施例提出了,紧固件52可以是铆钉、柱、夹具或接合板主体32的其他装置。保持构件54可以是垫圈,该垫圈径向向外突出足以与孔34或孔35交叠并且/或者接触位于相应孔内的锚的头部。保持构件54也可以与紧固件52一体从而提供与锚接触并且/或者与螺钉孔交叠的凸缘或头部。
其他类型的保持装置包括可旋转盘、杠杆或铆钉,其被成形成选择性地允许一个或多个锚被插入并且之后保持装置被移动到保持被插入锚的位置处;可变形部分(例如垫圈、夹子、C-环或突舌),其选择性地允许一个或多个锚被插入并且之后保持装置变形到保持位置;带/系绳机构,其可以被用于选择性地系住一个或多个锚;以及在不同位置之间移动的滑动构件,其选择性地允许一个或多个锚被插入并且至少该构件相对于被插入锚滑入保持位置内。
现在参考图3,示出了板130的另一个实施例,该板130与上述板30相同,除了包括位于孔34内的另一个端口结构132的实施例。如所示,同样的端口结构133或者如这里讨论的是任意其他实施例的端口结构可以位于孔35内。端口结构132可以包括第一端口元件134和第二端口元件136。端口元件134、136均相同于上述的端口结构44、45。然而,使用桥接或连结元件138将近端134a、136a彼此连接在一起,其中所述桥接或连结元件138跨过纵向轴线L横贯轴向地延伸。连结元件138可以包括孔隙(未示出)从而允许保持装置50、50′的紧固件52到其的通道和接合。连结元件138可以位于在孔34之间延伸的凹进60内,且该凹进60形成在主体32的近端表面37内。
现在参考图4-6,示出了另一个实施例的板230,该板230可以相同于上述的板30,除了包括位于孔34内的另一个端口结构232的实施例。如所示,同样的端口结构233或者如这里讨论的是任意其他实施例的端口结构可以位于孔35内。端口结构232可以包括第一端口元件234和第二端口元件236。使用桥接或连结元件238将近端元件234、236彼此连接在一起,其中所述桥接或连结元件238跨过纵向轴线L横贯轴向地延伸。
端口元件234、236均包括具有在其中延伸的圆形通孔的环状形状,且该通孔与板主体32邻近远端表面36的相应孔34、35对齐。连结元件238包括沿其远端部分的远端底座242以及从底座242向近端延伸出的近端插座244。插座244包括从其中向近端且向远端开口的中心孔隙240。孔隙240可以具有内部螺纹从而在其中接收紧固件52。插座244可以进一步包括近端凸缘246,该近端凸缘246可以从孔隙240径向向外延伸从而将端口结构240容易地附连到板主体232且使得板主体被夹在凸缘246和底座242之间。此外,底座242可以在至少一个方向内是非圆形的或细长的,例如如所示沿纵向轴线L,从而抵抗端口结构232相对于板主体32的旋转。
现在参考图7-8,示出了另一个实施例的板330。该板330可以相同于上述的板30,并且类似元件使用相同参考数字被标出。板330包括针对保持装置的端口结构332以及位于孔对35之间的第二端口结构333,其中所述端口结构332在中心定位于孔对34之间。端口结构332、333均包括底座部分336和从底座部分336向近端延伸出的插座338。插座338包括在其中向近端且向远端开口的中心孔隙340。孔隙340可以具有内部螺纹从而在其中接收紧固件52。
插座338可以进一步包括近端保持凸缘346,该近端保持凸缘346可以变形以从孔隙340径向向外延伸从而将端口结构332、333容易地附连或钉到板主体32上且使得板主体被夹在凸缘346和底座336之间。在所述实施例中,凸缘346包括沿邻近孔隙340的表面的锥形壁表面346a。成形器械的球状构件可以被定位于邻近这个锥形表面346a并且其被推抵以径向向外地弯曲或辊制凸缘346,使其抵靠并邻近板主体32的近端表面。此外,底座336可以在至少一个方向内是非圆形的或细长的,例如如所示沿纵向轴线L,从而抵抗端口结构332、333相对于板主体32的旋转。
现在参考图9-10,示出了具有另一个实施例的端口结构410的另一个实施例的板430。该板430包括板主体432,该板主体432具有沿纵向轴线L以延伸过三个椎骨的长度,不过也可以想到具有单个高度和其他多个高度的板的应用。板430包括邻近第一端的第一孔对434和邻近第二端的第二孔对435。第三孔对436沿板430大约在中间长度处。骨螺钉形式的锚18位于孔对436中的一个孔内,可以理解其他孔可以具有位于其中的锚18从而将板固定到底层椎骨主体上。
板430进一步包括多个固定在其上的保持装置450。相应的保持装置位于孔对434、435、436中的相应孔之间。保持装置450包括近端凸缘元件454和附连到板主体432的远端紧固件部分(未示出)。凸缘元件454可以包括其附近的一对镂空或凹进,所述一对镂空或凹进可被定位于邻近相应相邻孔对的相应孔从而允许锚插入到孔内。其后保持装置可以旋转,这样凸缘元件454交叠相应相邻孔并且阻挡或防止锚从板孔中退出。
端口结构410包括近端凸缘412和远端凸缘414和在其间延伸的主体416。近端凸缘位于邻近板主体432的近端表面439,并且远端凸缘414位于邻近远端表面438。主体416包括远端部分418和近端部分420。远端部分418包括直线内表面422,该直线内表面422限定圆柱形形状从而接收其中的锚18的轴18b。近端部分420包括凹曲内表面424,该凹曲内表面424接合锚18的头部18a的下侧。主体416可以包括在凸缘412、414之间延伸的凸曲外表面426。板主体432位于凸缘412、414之间,并且当锚18被置于抵靠其上时外表面426和凸缘412、414防止端口结构410通过板主体432被推向远端。
这里讨论的端口结构可以由具有大于板材料刚性的任意适当的包括钛、不锈钢和铝的生物相容的金属或金属合金、陶瓷材料、聚合物和其他塑料或弹性体制成。端口结构可以锻造成所需形状或者使用任意适当的工艺或技术被成形。端口结构具有针对锚和/或锚保持装置与板主体之间的改进的交界面。
可以想到将端口结构固定到板上的各种技术。端口结构的至少一部分可以被装埋在板主体内从而接合其上的端口结构。端口结构可以被压制成与板主体形成适配接合。端口结构可以包括必定接合板的机械结构或紧固件。板可以绕端口结构被过模制成(over-molded)或绕端口结构而成形。端口结构也可以位于板开口或凹进内并且变形从而确实地接合板主体。
虽然上面仅详细描述了本发明的几个示例性实施例,不过本领域的技术人员可以容易地想到在实质上不脱离本发明的新颖教导和优点的情况下可能存在对示例性实施例的许多改型。同样,关于一些实施例在上面进行描述和讨论的特征可以与关于另一些实施例在上面描述和讨论的特征相结合。因此,所有这些改变意于被包括在本发明的范围内。

Claims (34)

1.一种用于稳定脊柱节段的板固定系统,其包括:
在第一端和相对的第二端之间沿纵向轴线延伸的板主体,所述板主体包括可位于邻近所述脊柱节段的远端表面以及相对的近端表面,所述板主体进一步包括在所述远端表面和所述近端表面之间延伸的至少一个孔;以及
位于所述至少一个孔的至少一部分周围的端口结构,所述端口结构包括邻近所述板主体的所述远端表面的远端部分以及邻近所述板主体的所述近端表面的近端部分,所述远端部分包括限定所述至少一个孔的圆柱形部分的内表面,所述近端部分包括限定所述至少一个孔的凹进部分的内表面,从而在其中接收锚的头部。
2.根据权利要求1所述的板固定系统,其中所述板主体由第一材料制成,所述端口结构由第二材料制成,并且所述端口结构的刚性大于所述板主体。
3.根据权利要求2所述的板固定系统,其中所述第一材料是PEEK并且所述第二材料是金属或金属合金。
4.根据权利要求1所述的板固定系统,其进一步包括所述锚位于所述端口结构内且所述锚的所述头部接触所述近端部分并且所述锚的轴延伸通过所述远端部分。
5.根据权利要求1所述的板固定系统,其中所述端口结构包括远端凸缘和近端凸缘和在所述远端凸缘和所述近端凸缘之间延伸的主体,所述主体包括所述沿其延伸的所述远端和近端部分的所述内表面。
6.根据权利要求5所述的板固定系统,其中所述端口结构的所述主体包括限定在所述近端凸缘和远端凸缘之间的凸的弯曲形状的外表面,并且所述近端凸缘和远端凸缘从所述外表面向外突出。
7.根据权利要求6所述的板固定系统,其中所述近端凸缘被定位成接触所述板主体的所述近端表面,所述远端凸缘被定位成接触所述板主体的所述远端表面。
8.根据权利要求5所述的板固定系统,其中所述近端凸缘被定位成接触所述板主体的所述近端表面,所述远端凸缘被定位成接触所述板主体的所述远端表面,所述板主体在所述近端凸缘和远端凸缘之间延伸。
9.一种用于稳定脊柱节段的板固定系统,其包括:
在第一端和相对的第二端之间沿纵向轴线延伸的板主体,所述板主体包括可位于邻近所述脊柱节段的远端表面以及相对的近端表面,所述板主体进一步包括在所述远端表面和所述近端表面之间延伸的至少一个孔;以及
位于所述至少一个孔的至少一部分周围的端口结构,所述端口结构包括邻近所述板主体的所述远端表面的远端部分以及插座,该插座从所述远端部分向近端延伸到邻近所述板主体的所述近端表面的凸缘,其中所述凸缘从第一位置变形到第二位置,其在所述第一位置处从所述插座向近端延伸,在所述第二位置处从所述插座径向向外延伸与所述板主体接合。
10.根据权利要求9所述的板固定系统,其中所述插座包括通过所述凸缘向近端开口的孔隙。
11.根据权利要求10所述的板固定系统,其中所述孔隙具有沿所述插座的内部螺纹。
12.根据权利要求11所述的板固定系统,其进一步包括螺纹地接合在所述插座内的保持装置。
13.根据权利要求12所述的板固定系统,其进一步包括位于所述至少一个孔的相对侧上的一对孔,所述一对孔均包括绕其延伸的端口结构。
14.根据权利要求9所述的板固定系统,其中所述端口结构的所述远端部分包括从所述插座向外延伸的凸缘。
15.根据权利要求14所述的板固定系统,其中所述凸缘包括非圆形的形状。
16.一种用于稳定脊柱节段的板固定系统,其包括:
在第一端和相对的第二端之间沿纵向轴线延伸的板主体,所述板主体包括可位于邻近所述脊柱节段的远端表面以及相对的近端表面,所述板主体进一步包括在所述远端表面和所述近端表面之间延伸的至少两个孔;以及
端口结构,所述端口结构包括在所述远端表面和所述近端表面之间的所述至少两个孔的各自的一部分周围的第一端口元件和第二端口元件以及在所述第一端口元件和第二端口元件之间延伸并且使所述第一端口元件和第二端口元件彼此连接的连结元件。
17.根据权利要求16所述的板固定系统,其中所述第一端口元件和第二端口元件均包括:
邻近所述板主体的所述远端表面的远端部分以及邻近所述板主体的所述近端表面的近端部分,所述远端部分包括限定所述至少两个孔的各自的圆柱形部分的内表面,所述近端部分包括限定所述至少两个孔的各自的凹进部分的内表面。
18.根据权利要求17所述的板固定系统,其中所述连结元件在所述端口元件的所述近端部分的近端之间延伸并且连接所述端口元件的所述近端部分的近端。
19.根据权利要求18所述的板固定系统,其中所述板包括在所述近端表面内在所述至少两个孔之间延伸的凹进,并且所述连结元件位于所述凹进内。
20.根据权利要求19所述的板固定系统,其进一步包括延伸通过所述连结元件且与所述至少两个孔交叠的保持装置。
21.根据权利要求16所述的板固定系统,其中所述端口结构的所述第一端口元件和所述端口元件均包括带有通孔的环形主体,其中所述通孔与所述板邻近所述板主体的所述远端表面的所述至少两个孔中的各自孔对准。
22.根据权利要求21所述的板固定系统,其中所述连结元件包括在所述端口元件之间延伸的底座部分和从所述底座部分向近端延伸的插座。
23.根据权利要求22所述的板固定系统,其中所述插座包括中心且向近端开口的孔隙以接收在所述板主体的所述至少两个孔之间的保持装置。
24.根据权利要求23所述的板固定系统,其中所述插座绕所述孔隙车有螺纹。
25.根据权利要求23所述的板固定系统,其中所述底座部分包括非圆形形状并且所述插座包括从所述底座部分向近端延伸的圆形圆柱形状。
26.根据权利要求16所述的板固定系统,其中所述板主体由第一材料制成并且所述端口结构由第二材料制成,并且所述端口结构的刚性大于所述板主体。
27.根据权利要求26所述的板固定系统,其中所述第一材料是PEEK,所述第二材料是金属或金属合金。
28.根据权利要求16所述的板固定系统,其进一步包括位于所述板主体的所述至少两个孔内的锚,所述锚延伸通过相应的所述端口元件。
29.根据权利要求28所述的板固定系统,其进一步包括保持装置,该保持装置接合到所述锚之间的所述连结元件且与所述至少两个孔成交叠关系。
30.一种用于形成脊骨板的方法,其包括:
用非刚性材料形成所述板的主体且所述主体在其第一端和相对的第二端之间沿纵向轴线延伸,所述主体进一步包括可位于邻近脊柱的远端表面以及相对的近端表面以及在所述远端表面和所述近端表面之间延伸的至少两个孔;以及
将刚性端口结构装埋在所述板的所述主体中,所述端口结构的至少一个端口元件与所述至少两个孔的各自孔对准,且所述端口元件使用桥接元件彼此相连。
31.根据权利要求30所述的方法,其中装埋所述刚性端口结构包括将所述桥接元件置于凹进内,该凹进形成在所述至少两个孔之间所述主体的所述近端表面内。
32.根据权利要求31所述的方法,其进一步包括通过所述凹进内的所述桥接元件固定保持装置。
33.根据权利要求30所述的方法,其中所述桥接元件包括邻近所述主体的所述远端表面的底座以及从所述底座向近端延伸的插座,并且所述方法进一步包括将保持装置固定在所述插座内且与所述至少两个孔成交叠关系。
34.根据权利要求30所述的方法,其进一步包括将锚置于所述至少两个孔中的一个孔内与相应端口元件接触。
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