CN102036623A - 可膨胀的椎间植入体 - Google Patents
可膨胀的椎间植入体 Download PDFInfo
- Publication number
- CN102036623A CN102036623A CN200980118841XA CN200980118841A CN102036623A CN 102036623 A CN102036623 A CN 102036623A CN 200980118841X A CN200980118841X A CN 200980118841XA CN 200980118841 A CN200980118841 A CN 200980118841A CN 102036623 A CN102036623 A CN 102036623A
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- CN
- China
- Prior art keywords
- outer sleeve
- composition surface
- inner core
- intervertebral implant
- sleeve part
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
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Abstract
本发明提供了一种可膨胀的椎间植入体(20),其用于插入由相邻椎骨限定的椎间空间中。该可膨胀的椎间植入体包括一对外部套筒部分(30A、30B)和布置在外部套筒部分之间的内部芯(50)。内部芯相对于外部套筒部分的运动使得外部套筒部分相互偏转离开,从而使得可膨胀的椎间植入体与椎骨接合,并调节椎间空间的高度。
Description
相关申请的交叉引用
本申请要求美国临时专利申请No.61/042724(申请日为2008年4月5日)的权益,该文献的内容被本文参引,如同它整个在本文中阐述。
技术领域
本发明通常涉及椎间植入体,特别是涉及一种椎间植入体,该椎间植入体可膨胀,以便产生相邻椎骨的所需间隔和/或角取向。
背景技术
退化的椎间盘疾病或椎骨本体的退化通常导致椎间盘高度损失,这又可能特别引起骨小面和神经碰撞。一种标准治疗是用椎间植入体代替受损的椎间盘,或者由椎间植入体代替受损的部分或整个椎骨本体。
因此,椎间植入体可以插入两个相邻椎骨本体的椎间盘空间中,或者插入在除去脊柱的受损部分后由于除去部分或整个椎骨本体而产生的空间内。优选地,椎间植入体使得脊柱尽可能地恢复至自然状态。也就是,植入体优选地恢复椎间盘的初始高度,因此恢复两个相邻椎骨本体之间或在各个高度的脊柱中的椎骨本体之间的初始距离。这些植入体的尺寸和形状设置成至少填充在椎骨本体之间的生理高度,并通过相对狭窄和较小的切口插入,其中,神经和脉管结构靠近切口的侧部。因此,优选地发展一种植入体,它可以以减小的尺寸或结构插入,并当定位在椎骨之间时膨胀,以使所需的切口最小,并限制植入体在植入过程中接触神经和脉管结构的可能性。
希望构造一种椎间植入体,它使得脊柱恢复它的自然状态,它在插入过程中相对紧凑,并当定位在相邻椎骨之间时可以膨胀。还希望构造一种可膨胀的椎间植入体,它可以利用相同仪器来插入和膨胀。
发明内容
下面的概述用于以简化形式来介绍概念的选择,它们将在后面的具体实施方式的详细说明中进一步介绍。本概述并不能指出本发明的关键特征或基本特征,也不是用于限制本发明的范围。本发明的范围由权利要求来限定。
某些实施例涉及一种可膨胀的椎间植入体,用于插入椎间盘空间中,并可从初始位置膨胀至膨胀位置。可膨胀的椎间植入体包括联接装置,该联接装置包括沿纵向方向连接的多个联接件。各联接件包括外部套筒,该外部套筒有第一外部套筒部分和可相对于该第一外部套筒部分运动的第二外部套筒部分。第二外部套筒部分限定了第一接合表面,该第一接合表面相对于纵向方向倾斜。各联接件还包括布置在第一和第二外部套筒部分之间的内部芯。该内部芯限定了相对于纵向方向倾斜的第二接合表面,其中,该第二接合表面抵靠第一接合表面。在内部芯和第二外部套筒部分之间沿纵向方向的相对运动使得第一接合表面沿第二接合表面行进(ride),从而使得第二外部套筒部分沿与纵向方向基本垂直的方向偏转离开第一外部套筒部分。
通过下面参考附图对示例实施例的详细说明,将清楚附加特征和优点。
附图说明
当结合附图阅读时将更好地理解前面的概述以及后面的详细说明。附图中表示了示例实施例,在全部附图中,相同参考标号对应于相同元件。可膨胀的椎间植入体和相关方法并不局限于所述的特定实施例和方法,而是由权利要求来限定。
图1A是根据一个实施例构成的可膨胀的椎间植入体的透视图,该椎间植入体安装在椎间空间中;
图1B是类似于图1A的透视图,但是根据可选实施例的椎间植入体安装在椎间空间中;
图2A是图1中所示的可膨胀的椎间植入体的截面侧视图,该椎间植入体构成为联接装置,根据一个实施例,该联接装置包括多个可膨胀的椎间联接件,其中,植入体处于第一收缩位置;
图2B是图2A中所示的可膨胀的椎间植入体的放大部分图;
图3A是图2A中所示的椎间植入体的可膨胀的椎间联接件的侧视图;
图3B是类似于图3A的可膨胀的椎间联接件的侧视图,但是根据可选实施例构成;
图3C是类似于图3A的可膨胀的椎间联接件的侧视图,但是根据另一可选实施例构成;
图4A是图3A中所示的可膨胀的椎间联接件的截面端视图;
图4B是类似于图4A中所示的可膨胀的椎间联接件的截面端视图,但是根据可选实施例构成;
图5是图2A中所示的可膨胀的椎间联接件的截面侧视图;
图6是图5A中所示的可膨胀的椎间植入体的截面侧视图,该椎间植入体与插入装置连接;
图7是图6中所示的可膨胀的椎间植入体的截面侧视图,但是表示处于第二竖直膨胀位置;
图8A是图7中所示的可膨胀的椎间植入体的俯视图,该椎间植入体包括保持器,该保持器固定可膨胀的椎间植入体的各个部件;
图8B是图8A中所示的可膨胀的椎间植入体的截面端视图;
图8C是图8B中所示的可膨胀的椎间植入体的一部分的放大视图;
图9A是类似于图8B的可膨胀的椎间植入体的截面端视图,但是表示了根据可选实施例构成的保持器;
图9B是图9A中所示的可膨胀的椎间植入体的侧视图;
图10是类似于图6的可膨胀的椎间植入体的截面侧视图,但是根据可选实施例设置成在膨胀时提供脊柱前凸的外部轮廓;
图11是图10中所示的可膨胀的椎间植入体的截面侧视图,但是表示植入体处于垂直膨胀位置;
图12A是图10中所示的可膨胀的椎间植入体的俯视图;
图12B是图12A中所示的可膨胀的椎间植入体的一部分的放大侧视图;
图13是可膨胀的椎间植入体的侧视图,它包括根据可选实施例构成的第二保持器;
图14是类似于图10的可膨胀的椎间植入体的截面侧视图,但是根据可选实施例设置成在膨胀时限定脊柱前凸的外部轮廓;
图15A是类似于图6中所示的可膨胀的椎间植入体的俯视剖视图,但是根据可选实施例还设置成用于侧向膨胀,其中,可膨胀的椎间植入体表示处于侧向收缩位置;
图15B是图15A中所示的可膨胀的椎间植入体的截面端视图,其包括根据一种实施例构成的保持器;
15C是类似于15B中所示的可膨胀的椎间植入体的截面端视图,但是表示可膨胀的椎间植入体处于竖直和侧向膨胀位置;
图15D是类似于图15C的可膨胀的椎间植入体的截面端视图,但是包括根据可选实施例构成的保持器;
图16A是可膨胀的椎间植入体的侧视图,根据一个实施例,该椎间植入体与插入装置的偏压元件连接;
图16B是图16A中所示的可膨胀的椎间植入体的侧视图,但是偏压元件与插入装置的附加部件连接,其中,插入装置表示处于脱开位置;
图16C是图16B中所示的可膨胀的椎间植入体的侧视图,但是表示插入装置处于接合位置;
图17A是如图16C中所示的可膨胀的椎间植入体的侧视图,但是表示插入装置包括中心套筒,该中心套筒具有将插入装置锁定在接合结构中的连接元件;
图17B是图17A中所示的中心套筒的侧视图;
图17C是图17B中所示的中心套筒的俯视图;
图18A是根据可选实施例的可膨胀的椎间植入体的俯视图,该椎间植入体与角形插入装置连接;
图18B是图18A中所示的、与角形插入装置连接的可膨胀的椎间植入体的俯视图,表示了插入装置处于角形位置;
图19A是可膨胀的椎间植入体的截面侧视图,表示处于膨胀位置;以及
图19B是图19A中所示的可膨胀的椎间植入体的截面侧视图,但是表示了凸出部分在植入体达到最终膨胀位置之后除去。
具体实施方式
下面的说明书中使用的某些术语只是为了方便,而不是限定。词语“右”、“左”、“下”和“上”表示所参考的图中的方向。词语“向内”或“远端”和“向外”或“近端”是指分别朝向和远离可膨胀的植入体、仪器和相关部件的几何中心的方向。词语“前面”、“后面”、“上面”、“下面”和相关词语和/或短语是指所参考的人体的优选位置和方位,而不是进行限制。术语包括上述词语、衍生词和类似意思的词。
参考图1A,可膨胀的椎间植入体20表示为安装在由一对相邻或邻近的上部和下部椎骨24限定的椎间盘空间22内。可膨胀的椎间植入体20可以设置成与椎骨24熔合。椎骨24可以是腰椎,该腰椎限定前侧AS和相对的后侧PS。椎骨24还限定了相对的侧向侧LS,该侧向侧LS布置在沿中间外侧(mediolateral)方向延伸的中心中间轴线M-M的相对侧。椎骨24表示为沿上下(caudocranial)轴线C-C间隔开。可膨胀的椎间植入体20大致沿纵向方向L、侧向方向A和横向方向T延伸。
因此,各种结构介绍为沿纵向方向“L”和侧向方向“A”水平延伸以及沿横向方向“T”竖直延伸。壳体沿纵向方向L为细长的。除非另外说明,术语“侧向”、“纵向”和“横向”用于说明各分量的垂直方向分量。方向术语“向内”和“内部的”、“向外”和“外部的”以及它们的衍生词相对于给定装置使用,表示沿朝向装置的几何中心和离开该几何中心的方向分量的方向。
应当知道,尽管纵向和侧向方向表示为沿水平平面延伸,而横向方向表示为沿竖直平面延伸,但是在使用过程中包含各个方向的平面可以不同。因此,方向术语“竖直”和“水平”用于说明所示可膨胀的椎间植入体20和它的部件时只是为了清楚和示例目的。
在所示实施例中,纵向方向L沿前后方向延伸,侧向方向A沿中间外侧方向延伸,而横向方向T沿上下方向延伸。不过,应当知道,由可膨胀的椎间植入体20限定的方向可以选择地相对于由椎骨24限定的各方向成在0°和180°之间的任意所需角度。例如,植入体的纵向和侧向方向可以定向成相对于中间外侧方向和前后方向成0°和180°之间的任意所需角度。由下面所述可知,可膨胀的椎间植入体20可以沿前部方向、后部方向、或者相对于前后侧在0°和180°之间的任意可选方向插入椎间盘空间22中。
例如,图1B表示了可膨胀的椎间植入体20,其以沿相对于图1A所示的方位旋转180°的方位安装至椎间空间22中。在这方面应当知道,植入体20可以从前部或后部方向插入椎间空间22中,或者从与前部或后部方向成角度偏离的方向插入。当植入体20插入椎间空间22中时(例如从后部),可以除去后部的解剖学元件,例如韧带、部分或全部层状体、后弓、以及一些或全部骨小面关节,它们与接收植入体的椎骨空间对齐。尽管在图1A中将一个植入体20表示为插入椎间空间22中,在图1B中将一对植入体20插入椎间空间22中,但是根据需要任意所需数目的植入体20可以插入给定的椎间空间,例如在1和4个植入体之间。还应当知道,当执行椎体次全切除或半椎体切除时,一个或多个植入体20可以安装在椎间空间22中。
下面参考图2A、3A和4A,可膨胀的椎间植入体20可以提供为纵向细长联接装置26,该联接装置26包括一个或多个联接件28。植入体20可以由任意合适的生物可相容、射线可透过的材料或金属材料来制造,例如钛。联接装置26的联接件28可以是基本类似或相同地构成,除非另外说明。各联接件包括外部套筒30,该外部套筒30由一对竖直相对的上部和下部外部套筒部分30A和30B形成。外部套筒部分30A和30B各自限定了侧向细长横梁31,该横梁31与一对外部腿状物33连接,各外部腿状物33从横梁31的相对外部侧向端向内横向凸出。因此上部套筒部分30A包括从相应横梁31的侧向外端向下凸出的腿状物33,下部套筒部分30B包括从相应横梁31的侧向外端向上凸出的腿状物33。当联接件28处于第一或初始收缩位置时,侧向对齐腿状物33的横向内端可以相互抵靠,如图所示,以便在安装至椎间空间22内之前使植入体20的高度最小,或者它们可以选择地间隔。
各横梁31可以限定相应椎骨接合表面32,使得上部套筒部分30A的椎骨接合表面是朝上表面,下部套筒部分30B的椎骨接合表面是朝下表面。各椎骨接合表面32设置成抵靠相应上部和下部的相邻椎骨24。
各外部套筒部分30A和30B可以包括多个齿34,这些齿34从各椎骨接合表面32横向凸出。齿34沿侧向可以是细长的,或者可以布置为多个纵向间隔的排36,如图所示。齿34横过该多排36可以有基本恒定的高度,从而限定了基本线性的齿形轮廓,如图3A中所示。也可选择,齿34可以横过这些排限定非线性轮廓。例如,如图3B中所示,一个或多个联接件28的多排齿可以限定了弓形轮廓或凸形,因此,纵向中间排的齿34的高度大于纵向外部排的齿。轮廓可以绕穿过联接件28的纵向中点的侧向轴线对称或不对称。
也可选择或者另外,参考图4A,一排或多排36的齿34(直到全部排的齿)可以沿侧向方向为弓形,使得侧向中间部分的齿34的高度大于侧向外部部分的齿。轮廓可以绕穿过联接件28的侧向中点的纵向轴线对称或不对称。因此,齿34可以沿一个以上的方向限定凸形或弓形的轮廓。尽管齿34表示为侧向细长,但是应当知道,齿34可以选择为沿侧向方向不连续地横过椎骨接合表面32。例如,参考图4B,第二多个齿34可以沿侧向方向从椎骨接合表面32向外凸出。因此各排36可以包括一个或多个齿34,以便沿椎骨接合表面32形成一组侧向间隔和纵向间隔的齿34。齿34可以沿侧向轴线基本竖直对齐,或者可以为弓形,如图4B中所示,以便限定沿侧向方向的凸形轮廓,使得侧向中心齿34的高度大于给定排36的侧向外部齿的高度。也可选择或者另外,齿34可以为弓形,如图3B中所示,以便限定沿纵向方向的凸形轮廓。
齿34可以帮助使得椎骨表面粗糙,以便帮助可膨胀的椎间植入体与相邻椎骨熔合,并可以提供抓在椎骨上的表面,且与扁平椎骨接合表面相比还可以限定与相邻椎骨熔合的增加的表面面积。也可选择,一个或两个相对椎骨接合表面32可以沿侧向和纵向方向基本平滑、或者没有齿,如图3C中所示。平滑表面可以基本沿纵向-侧向平面延伸,或者可以沿侧向和纵向方向中的任意一个或两个成弓形。
继续参考图2A,联接装置26可以包括一个或多个联接件28,例如多个邻接联接件28,如图所示。各联接件28可以以上述方式包括侧向横梁31和一对相对横向腿状物33。各联接件28可以限定大致矩形或正方形,具有直的或弯曲的拐角、边缘和表面,或者有任意合适的可选几何形状。联接装置26限定了纵向前端27和相对的纵向后端29。联接装置26的后端29可以在几何形状上设置成用于插入椎间盘空间22中。例如,布置在联接装置后端29处的联接件28的横梁可以沿从前端27朝着后端29的方向横向向内弯曲,从而当植入体20插入椎间盘空间22中时提供引导表面。
相邻联接件28可以成一体连接,或者可以利用任意合适的机械连接元件或粘接连接元件而在连接位置被仔细地相互固定。例如,连接元件35可以从相邻联接件28的各腿状物33朝着相邻联接件28纵向向外凸出,使得一个联接件28的上部套筒部分30A的连接元件35附接在相邻联接件28的上部套筒部分30A的相应连接元件35上。同样,一个联接件28的下部套筒部分30B的连接元件35附接在相邻联接件28的下部套筒部分30B的相应连接元件35上。连接元件35可以为柔性或者刚性,并可以与相应腿状物33形成一体,或者仔细连接。联接装置26可以根据需要包括任意数目的联接件28,使得各联接件28的上部套筒部分30A进行连接,且各联接件28的下部套筒部分30B进行连接。
下面参考图2A和5,各外部套筒部分30A和30B的横梁31限定了外部椎骨接合表面32,如上所述,还限定了相对的横向内部接合表面40,该内部接合表面40在相对横向腿状物33之间侧向延伸。内部接合表面40竖直倾斜,以便相对于纵向轴线L-L限定角度θ,该角度θ可以在0°和90°之间,例如在大约10°和大约50°之间,使得各外部套筒部分的接合表面40沿纵向方向从联接装置26的后端29朝着前端27横向向内倾斜。因此,上部套筒部分30A的内部接合表面40沿纵向方向从联接装置26的后端29朝着前端27竖直向下倾斜,而下部套筒部分30B的内部接合表面40沿纵向方向从后端29朝着前端27竖直向上倾斜。
上部套筒部分30A的接合表面40限定的角度θ可以大于或小于下部套筒部分30B的接合表面40限定的角度,从而使得上部套筒部分30A分别以相对于下部套筒部分30B更高或更低的膨胀速率来膨胀。在这一点,应当知道,一个内部接合表面40相对于纵向轴线L-L的角度θ可以为零,而另一个接合表面40相对于纵向轴线L-L的角度θ不为零,从而只使得该另一接合表面的外部套筒部分在操作过程中膨胀。
各联接件28的内部接合表面40可以与联接装置26的其它联接件28的接合表面40对齐和平行延伸。因此,各联接件28的外部套筒30在它的前端横向延伸距离可以大于在它的后端的距离。各联接件28还可以包括作为一个或多个凸起的接合表面,或者该接合表面从接合表面40横向向内延伸。凸起可以为脊、齿或类似结构的形式,其设置成与互补结构配合,以便将植入体固定在膨胀位置。在所示实施例中,凸起表示为从接合表面40横向向内凸出的反向角度齿44。因此,为了说明,在本文中,接合表面或者一个或多个凸起将称为齿。
齿44从上部套筒部分30A的接合表面40向下凸出,且齿从下部套筒部分30B的接合表面40向上凸出。齿44可以限定:根端部45,该根端部45基本与相应接合表面40成一直线;以及三角形尖端46,该三角形尖端46与接合表面横向偏离。相邻尖端46可以间隔任意所需距离,例如在大约0.5mm和大约5mm之间。各联接件28的齿44可以为基本相同的尺寸和形状,使得连接相邻齿40的尖端46的线平行于接合表面40延伸。外部套筒部分30A和30B还限定了布置在相邻齿44之间并由相邻齿44限定的囊袋43。因此,囊袋43的尺寸和形状基本与限定该囊袋43的相邻齿44相同。
各联接件28限定了内部空隙38,该内部空隙38在相对横梁31之间横向地以及在各外部套筒部分30A和30B的相对腿状物33之间侧向地延伸。联接装置26包括内部芯50,该内部芯50布置在各联接件28的内部空隙38中,并由外部套筒部分30A和30B保持。内部芯50可以抵靠横梁31的横向内表面40,使得在操作过程中,内部芯50相对于外部套筒30的纵向运动使得外部套筒30沿第一方向(例如竖直方向,见图7)以及可选的或附加的第二方向膨胀,该第二方向垂直于横向方向或竖直方向,例如水平方向(见图15A-C).
在图2A-2B所示的实施例中,内部芯50包括:芯本体52,该芯本体52限定了相对侧向表面,该相对侧向表面可以朝向或抵靠外部套筒的腿状物33;以及相对的横向外部或者上部和下部的接合表面54。内部芯50的、布置在一个联接件28内的部分可以利用任意合适的机械固定元件或粘接固定元件而与内部芯50的、布置在联接装置26的另一联接件28内的部分成一体连接或可选择地固定在其上。
当内部芯50安装在外部套筒30的内部空隙38中时,接合表面54可以与外部套筒部分30A和30B的相应倾斜接合表面40进行配合或抵靠。因此,接合表面54相对于纵向轴线L-L横向倾斜,因此平行于相应接合表面40延伸。内部芯50还可以包括接合元件,该接合元件作为从接合表面54横向向外伸出的一个或多个凸起。凸起可以为脊、齿或类似结构的形式,它设置成与互补结构配合,以便将植入体固定在膨胀位置。在所示实施例中,凸起表示为从接合表面54横向向外凸出的反向角度齿56。因此,为了说明目的,在本文中,接合元件或者一个或多个凸起指齿56。
齿56的尺寸和形状可以设置成与齿44基本相同,以便与齿44配合。齿56限定了:根端部,该根端部基本与相应接合表面54成一直线;以及三角形尖端60,该三角形尖端46与接合表面横向偏离。齿56可以为基本相同的尺寸和形状,使得连接相邻齿56的尖端60的线平行于接合表面54延伸。因此内部芯50的齿沿从联接件28的后部朝着联接件28的前部的方向横向向内布置。内部芯本体52还限定了布置在相邻齿56之间并由相邻齿56限定的囊袋57。因此,囊袋57的尺寸和形状基本与限定该囊袋57的相邻齿56相同。
继续参考图2B,齿44的尺寸和形状设置成与配合的齿56互锁,并处于在相邻齿56之间限定的囊袋57中。同样,齿56的尺寸和形状设置成与配合的齿44互锁,并处于在相邻齿44之间限定的囊袋43中。齿44和56可以限定锯齿形形状,该锯齿形形状进行底切,使得互锁的齿44和56的尖端46和60相互交叠一定距离D,该距离可以大于0mm和小于或等于2mm。因此,施加在联接件28上的横向压力使得齿44和56沿彼此进行凸轮运动至互锁位置,使得在尖端46和60之间的干涉将在植入体20插入椎间空间中的过程中阻止外部套筒30与内部芯50竖直分离。而且,当植入体20插入椎间盘空间22内时,身体组织将对着外部套筒30施加向前的纵向力,从而将齿44和56偏压至它们互锁的位置,因此,芯50相对于外部套筒30的运动允许沿纵向向前方向进行,但是防止沿纵向向后方向进行。
互锁的齿44和56的相对尖端46和60可以间隔一定横向距离,以便限定高度H,该高度H可以在0mm和大约3mm的范围内。齿44和56还可以相对于纵向轴线L-L限定角度θ2,该角度θ2在大约10°和大约50°之间。
下面参考图6,联接装置26可以与插入工具70连接,该插入工具70包括偏压元件64、内部保持套筒72和外部保持套筒74。偏压元件64可操作成使得内部芯元件50相对于外部套筒30纵向向前运动。在所示实施例中,内部芯本体52限定了内部的纵向细长孔62,该纵向细长孔62的尺寸和形状设置成接收偏压元件64,该偏压元件64可以提供为纵向延伸杆或线66,该纵向延伸杆或线66在线66的一个纵向端处与横向止动器68连接。线64可以由维他良(vitalium)、钛等来制造。止动器68的尺寸和形状设置成抵靠最后侧联接件28的内部芯50(而不是外部套筒)的后表面,且线66可以沿联接装置26延伸穿过全部内部芯本体52的孔62,并从联接装置的前端27向前伸出。线66可以通过干涉配合或任意合适固定机构而在孔62内保持就位。
内部环形保持套筒72在从联接装置26的前端27向前的位置包围线66,并可以在操作过程中引导该线66。线66可以相对于内部保持套筒72沿纵向向前方向拉动,使得内部保持套筒72抵靠最前侧联接件的芯本体52的前端。内部保持套筒72和芯本体52的接合使得用户能够在插入椎间空间22内的过程中保持植入体20的位置控制,这是因为拉伸力施加在线66上。
外部环形保持套筒74设置成在并不与芯本体52横向对齐的位置处抵靠在最前侧外部套筒30的前端。外部保持套筒74提供了往复运动偏压元件,该往复运动偏压元件可操作成提供偏压力,该偏压力等于从偏压元件64施加给芯50的力,且与该力相反。在这一点上,外部保持套筒74可以称为支杆元件。
因此,当第一力F1沿纵向向前方向施加给线66时,止动器68向后部联接件28施加相应的纵向向前偏压力。外部保持套筒74向外部联接装置套筒30中施加力F2,该力F2等于力F1并与它相反。因此,施加在线62上的力F1使得内部芯50相对于外部套筒30纵向向前平移。
还参考图7,当内部芯50相对于外部套筒30向前平移时,接合表面40沿互补接合表面54行进,从而使得外部套筒部分30A和30B彼此远离地竖直偏转。当外部套筒部分30A和30B相互偏离时,椎间植入体20沿横向或竖直方向膨胀。上部和下部的配合接合表面40和54的斜率分别限定上部和下部套筒30A和30B膨胀的速率。
当内部芯50相对于外部套筒30沿向前方向运动时,接合元件或齿44和56的尖端46和60在彼此上面进行凸轮运动,从而使得植入体20的高度以基本等于齿44和56的高度H的递增量来增加。一旦达到所需高度且偏压力从线62上除去,接合的齿44和56允许外部联接装置套筒30相对于内部芯50沿纵向向前方向稍微相对运动,这可以使得套筒的外部齿34摩擦相邻椎骨24的内表面,从而方便套筒部分30A和30B与椎骨24的熔合。
一旦齿44和56互锁,在不向索缆66施加另外的偏压力的情况下将防止在内部芯50和外部套筒30之间的相对运动。因此应当知道,内部芯50相对于外部套筒30的线性向前运动使得椎间植入体20或外部套筒部分30A和30B从具有第一高度的初始或松弛位置膨胀至具有第二高度的第二或膨胀位置,该第二高度大于第一高度。齿44和56提供了接合元件,一旦椎间植入体20,外部套筒部分30A和30B到达所需的膨胀位置,该接合元件防止外部套筒部分30A和30B朝向彼此收缩。应当知道,当各联接件28的各接合表面40和54包括多个相应齿时,各接合表面40和54可以选择地包括一个或多个齿。
在操作过程中,植入体20在初始位置插入椎间空间22中,随后膨胀至第二膨胀位置,以便使得相邻椎骨24抵靠和定位在所需的竖直位置,这使得椎间空间达到所需高度。因此,椎间植入体20可以称为椎间间隔件,它使得在相邻椎骨之间的椎间空间22增加至所需的上下高度。自体移植物或骨替代件可以在需要时环绕植入体20布置在椎间空间22中。
应当知道,如图6中所示,后部联接件28的芯本体52的尺寸可以设置成有比相应外部套筒30基本更长的纵向长度。因此,当植入体20处于初始或松弛位置时,芯50可以相对于最后侧联接件28的套筒30向后凸出偏移距离“O”。该偏移距离O可以例如基于接合表面44和54的斜率和外部套筒30的所需膨胀而预先选择,使得一旦植入体20到达所需的最终高度,芯50的后表面可以与后部联接件28的外部套筒30的后表面基本平齐,如图7中所示。
而且,图6表示了前部联接件28的芯本体52的前端,它在植入体20处于初始位置时与前部联接件28的外部套筒30的前端基本平齐。因此,如图7中所示,当植入体处于膨胀位置时,前部联接件28的芯本体52的前端从前部联接件28的外部套筒30的前端向前伸出。不过应当知道,当植入体20处于初始位置时,前部联接件28的芯本体52的前端可以选择地相对于前部联接件28的外部套筒30的前端凹入一定距离,该距离等于偏移距离O。因此,当植入体20处于膨胀位置时,前部联接件20的芯本体52的前端可以与前部联接件28的外部套筒30的前端基本平齐。
下面参考图8A-C,可膨胀的椎间植入体20可以包括呈一个或多个(例如多个)环带84形式的保持器元件,该环带84设置成对着联接件28施加压缩保持力,这可以在植入体20插入椎间空间22中和膨胀至竖直膨胀位置时帮助保持植入体20的结构完整性。特别是,联接装置26可以包括侧向相对的竖直狭槽82,该竖直狭槽82可以穿过连接元件35竖直延伸。连接元件35可以包括侧向部分,该侧向部分伸入布置在相邻联接件28之间的侧向延伸槽86内。
金属或弹性环带84可以穿过侧向相对狭槽82插入,并置于槽86中,使得环带84环绕外部套筒部分30A和30B的腿状物33。环带84可以包括终端85A和85B,该终端85A和85B形成互锁的舌-槽。因此,终端85A和85B可以夹在一起,且终端可以布置在一个狭槽82的内部,以便降低该环带84意外分离的可能性。环带84可以施加压力,该压力将外部套筒部分30A和30B朝向彼此和内部芯50偏压,从而帮助使得齿44和56保持在它们的互锁结构。环带84可以是射线可透过的,以便在植入处理过程中提供植入体20的位置和角度方位的指示。
下面参考图9A-B,可膨胀的椎间植入体20可以包括根据可选实施例构成的保持器元件。特别是,腿状物33并不限定竖直延伸穿过的横向狭槽。而是,弹性环带88可以在一个或多个联接件28上面拉伸,并插入槽86中。环带88的弹性可以施加压力,该压力将外部套筒部分30A和30B朝向彼此和内部芯50偏压,从而帮助使得齿44和56保持在它们的互锁结构。多个环带88可以是射线可透过的,以便在植入处理过程中提供植入体20的位置和角度方位的指示。
下面参考图10,可膨胀的椎间植入体可以构成为使得当植入体20处于膨胀位置时,椎骨接合表面32限定了脊柱前凸轮廓。根据所示实施例,接合表面40和54相对于各联接件28的纵向轴线L-L的斜率S对于不同联接件可变化。因此,一个联接件的相对接合表面40和54与相邻联接件的相应的相对接合表面40和54成角度或者并不平行。例如,各联接件28的各相接接合表面40和54相对于纵向轴线L-L的斜率的幅值沿从后部联接件28朝向前部联接件28的方向减小。因此,给定联接件28的互补接合表面40和54的斜率幅值将大于布置在前侧的联接件28的斜率,且小于布置在后侧的联接件28的斜率。
因此,当植入体20膨胀时,各联接件28的外部套筒部分30A和30B将以不同速率竖直移动。在所示实施例中,外部套筒竖直移动的速率将沿从后部联接件28朝着前部联接件的方向减小。当然,可以认为,各联接件的接合表面40和54的斜率可以选择沿从前部联接件28朝向后部联接件28的方向减小,使得竖直移动的速率将沿从前部联接件28朝向后部联接件28的方向降低,还可以选择,中间联接件28的膨胀速率可以比向前和向后间隔的联接件28大或小。
在图10所示的实施例中,相对的外部套筒部分30A和30B的椎骨接合表面32可以沿纵向方向基本扁平。各联接件28的相对椎骨接合表面32的斜率可以对于不同联接件而变化。因此,一个联接件的椎骨接合表面32将相对于相邻联接件的接合表面32成角度或并不平行。还可以说,各联接件28的接合表面32相对于纵向方向倾斜一定角度,该角度与另一联接件的接合表面32相对于纵向方向倾斜的角度不同。
给定联接件28的外部套筒部分30A和30B的相对接合表面32可以相对于纵向轴线L-L相等和相对。如图所示,联接件28的椎骨接合表面32各自相对于纵向轴线L-L限定的斜率的幅值将由一个联接件到一个联接件地减小,这是因为当植入体20处于初始位置时,相应接合表面40和54的斜率增加。因此,在所示实施例中,联接件28的各椎骨接合表面32的斜率的幅值将沿从联接装置26的前端27朝向联接装置的后端29的方向减小。给定联接件28的相对椎骨接合表面32的斜率幅值比布置在后端的联接件28的更大,比布置在前端的联接件28的更小。也可选择,各联接件28的相对椎骨接合表面32的斜率可以对于不同联接件基本相同。
下面参考图11,当内部芯50相对于外部套筒30纵向向前运动,以便使得植入体以上述方式从初始位置运动至膨胀位置时,联接件28以不同速率膨胀。特别是,给定联接件28以比布置在前侧的联接件更快的速率和以比布置在后侧的联接件更慢的速率来膨胀。因此,当椎间植入体20处于图11中所示的膨胀位置时,各联接件28的相对外部套筒部分30A和30B膨胀的距离大于布置在前侧的联接件的膨胀距离,小于布置在后侧的联接件的膨胀距离。因此植入体20限定了沿从前端27朝着后端29的方向相对于纵向轴线L-L横向向外倾斜的椎骨接合表面32。而且,各外部套筒部分30A和30B的椎骨接合表面32与联接装置26的其它联接件28的椎骨接合表面32成一直线,从而产生与椎骨24可靠的接合表面。
参考图12A-B,应当知道,联接件28可以连接成允许在相邻联接件之间相对竖直运动。因此,相邻联接件28可以通过接头(例如舌-槽接头90)来连接。接头90包括附接在相邻联接件28中的一个上的一对第一侧向相对接合元件92。该接合元件92竖直延伸,且各自包括倾斜表面94,该倾斜表面94沿纵向离开联接件28的方向侧向向内倾斜。相邻联接件28中的另一个包括第二侧向细长接合元件96,该接合元件96在相对接合元件92之间侧向延伸。接合元件竖直延伸,并包括侧向相对的倾斜表面98,该侧向相对的倾斜表面98沿纵向离开联接件28的方向侧向向外倾斜。倾斜表面94和98相互接合,以便使得相邻联接件对于纵向分离互锁,同时能够沿倾斜表面94和98进行相对竖直运动,因此允许在相邻联接件28之间相对竖直运动。保持器元件例如环带88还可以插入分离相邻联接件28的一个或多个槽86中,以便在以上述方式使用的过程中进一步保持联接装置26的结构整体性。
也可选择或者另外,可膨胀的椎间植入体20可以包括辅助保持器,例如图13中所示的柔性环带100。环带100限定了大致沿纵向方向延伸的本体101,并限定了一对相对的终端102,各终端102限定了连接位置,该连接位置可以与多个联接件28中的不同联接件的外部套筒部分30A或30B连接。终端102可以限定相对于外部套筒部分的铰接连接,或者可以限定固定连接,从而环带100的柔性允许终端102和其它连接位置相对于本体101旋转。环带100可以利用任意合适的机械紧固件来固定在外部套筒部分30A和30B上。
在所示实施例中,一个环带100的终端102与纵向最外侧联接件28的上部套筒部分30A的侧向外表面连接。另一环带100的终端102与纵向最外侧联接件28的下部套筒部分30B的侧向外表面连接。一对基本相同的环带可以与上部和下部套筒部分30A和30B的相对外部侧向表面连接。因此,环带100向布置在环带终端102之间的所有联接件28都提供纵向压力。也可选择,环带100可以与布置在环带100的终端102之间的一个或多个(直到全部)联接件28连接。
应当知道,图10-13表示了根据一个实施例设置成产生脊柱前凸轮廓的椎间植入体20,且表示了可选实施例可以用于产生脊柱前凸轮廓。例如,参考图13,各外部套筒部分30A和30B的椎骨接合表面32与相邻联接件的相应外部套筒部分30A和30B的椎骨接合表面32对齐。因此,各外部套筒部分30A的椎骨接合表面32相互对齐和平行,且各外部套筒部分30B的椎骨接合表面32相互对齐和平行。而且,各外部套筒部分30A和30B的接合表面32可以相对于纵向轴线L-L倾斜。在所示实施例中,接合表面32限定了斜率S1,该斜率S1为沿从联接装置26的前端27朝向联接装置的后端的方向从纵向轴线L-L横向向外形成的角度。不过,应当知道,接合表面32可以选择沿从联接装置26的前端27朝向联接装置的后端的方向从纵向轴线L-L横向向内倾斜。
而且,各外部套筒部分30A的接合表面40和50与另一联接件28的外部套筒部分30A的接合表面40和50对齐和平行延伸。同样,各外部套筒部分30B的接合表面40和50与另一联接件28的外部套筒部分30B的接合表面40和50对齐和平行延伸。因此,当植入体膨胀至如图13中所示的膨胀位置时,各联接件28以与其它联接件相同的移动速率横向向外移动,且椎骨接合表面32保持上述脊柱前凸轮廓。
因此,可膨胀的椎间植入体20设置成沿横向方向膨胀,并可以进一步设置成使得椎骨接合表面32可以在与椎骨接合时限定脊柱前凸轮廓。也可选择或者另外,椎间植入体20可以设置成使得联接件28的椎骨接合表面32组合以便限定非线性形状,例如具有外部纵向端的弯曲凸形形状,该外部纵向端相对于纵向中间部分横向向内布置。
参考图15A,各外部套筒部分30A和30B的腿状物33的相对轴向内表面可以限定侧向相对和竖直延伸的接合表面110,该接合表面110可以纵向伸长,并相对于纵向轴线L-L以任意所需角度侧向倾斜,如上面对于形成于内部接合表面40和纵向轴线之间的横向角度所述。因此,各套筒部分的接合表面110沿从前端27朝向联接装置26的后端29的方向从纵向轴线侧向向外倾斜。这样应当知道,侧向倾斜接合表面110可以相对于横向倾斜接合表面40如上所述构造。不过,各外部环形套筒的横梁31沿侧向方向不连续,使得外部套筒部分30A和30B的各腿状物沿侧向方向相对于相同外部套筒部分的另一腿状物自由运动。给定外部套筒部分的各腿状物以上述方式相对于相对外部套筒部分的腿状物沿横向方向自由运动。
上部套筒部分30A的接合表面110可以限定比另一个接合表面更大或更小的角度,还可以限定比下部套筒部分30B的接合表面110更大或更小的角度,从而使得外部套筒30的一个侧向侧部相对于外部套筒30的另一侧向侧部分别以更高或更低的膨胀速率来侧向膨胀。这样应当知道,一个或两个内部接合表面110相对于纵向轴线L-L的角度可以为零,而其它的接合表面110相对于纵向轴线L-L的角度并不为零,从而在操作过程中只使得外部套筒的一个侧向侧部沿侧向膨胀。
各联接件28的接合表面110可以与联接装置26的另一联接件28的接合表面110对齐和平行延伸。因此,各联接件28的外部套筒30可以在它的前端比它的后端侧向伸出更大量。各联接件28还可以包括呈反向角度齿114形式的接合元件,该齿114从接合表面110侧向向内凸出。侧向齿114可以参考横向齿44以上述方式来构成。
内部芯本体52限定了侧向外部接合表面124,该接合表面124设置成与上部和下部套筒30A和30B的接合表面110接合。内部芯本体52可以竖直延伸足够距离,使得各接合表面124可以与在套筒30的各侧向侧部上的一对互补接合表面110接合。接合表面124可以相对于纵向轴线L-L侧向倾斜,因此可以平行于相应接合表面110延伸。侧向接合表面124可以如上面对于横向接合表面54所述构成。内部芯50还可以包括呈反向角度齿126形式的接合元件,该齿126从接合表面124侧向向外凸出。齿126的尺寸和形状可以设置成基本与齿114相同,从而与齿114配合。齿126可以以上面对于齿56所述的方式来构成。
如图15B中所示,外部套筒部分30A和30B可以以上述方式由保持器例如多个环带84来保持。狭槽82可以竖直延伸穿过两对相对侧向外部腿状物33,且环带84可以插入狭槽82中,并以上述方式布置在槽86中,以便在联接装置上施加压缩保持力,从而有助于保证可膨胀的椎间植入体20的结构整体性。也可选择,如图15D中所示,保持器可以提供为弹性环带88,该弹性环带88以上面所述方式布置在槽86中,以便施加横向和侧向压缩固定力。
下面参考图15A和15C,当内部芯50相对于外部套筒30沿向前方向运动时,接合表面40沿互补的接合表面54行进,且齿44和56在彼此上面进行凸轮运动,从而使得外部套筒部分30A和30B以上述方式递增地相互远离地竖直偏转。而且,接合表面110沿互补接合表面124行进,且齿114和126在彼此上面进行凸轮运动,从而使得外部套筒30的侧向外部部分从第一侧向收缩位置向第二侧向膨胀位置递增地相互远离地侧向偏转。应当知道,接合表面110和124的斜率可以比接合表面40和54的斜率更大或更小,使得植入体20可以以比植入体20侧向膨胀速率更大或更小的速率竖直膨胀。
应当知道,可以提供一成套工具,该成套工具根据包括根据这里所述的任意实施例构成的全部或部分可膨胀的椎间植入体20。例如,该套工具可以包括可膨胀的椎间植入体的一个或多个部件,例如上部和下部的外部套筒部分30A和30B、内部芯50、环带84和88以及多个联接件28。包含在各套工具中的一个或多个部件可以有一个或多个变化特征,例如尺寸和/或形状。例如,第一套工具可以被提供为具有一个或多个部件,例如外部套筒部分30A和30B、内部芯50、环带84和88以及多个联接件28,它们有不同尺寸或形状,以便适应不同膨胀速率、不同纵向和/或侧向长度以及不同膨胀方向,例如单独横向膨胀或者与侧向膨胀一起进行横向膨胀。在给定成套工具中的一些部件可以使得植入体20以上述方式产生脊柱前凸轮廓,同时在该成套工具中的另一些部件可以使得植入体产生水平的上部和下部椎骨接合表面。该成套工具还可以包括插入工具70的部件,如下面所述。
特别是,下面参考图16A-C,插入工具70可以设置成与椎间植入体20接合,使得植入体20可以插入椎间空间22中,且随后以上述方式膨胀。一旦椎间植入体布置在椎间空间中,插入工具可以包括偏压元件,该偏压元件向植入体施加偏压力,从而使得植入体以上述任意方式膨胀。一旦植入体20达到所需膨胀位置,插入工具70就可以与植入体20脱开。
插入工具70可以包括:内部环形保持套筒72;偏压元件64,该偏压元件64在内部环形保持套筒72内部延伸;以及外部环形保持套筒74,该外部环形保持套筒74接收内部环形保持套筒72。一旦保持元件70运动至使得内部环形保持套筒72抵靠内部芯50且外部环形保持套筒74抵靠外部套筒30的位置,力F1可以施加给线66,该力使得植入体以上述方式膨胀。
参考图17A-C,内部环形保持套筒72可以包括纵向细长本体151,该细长本体151有在远端处的螺纹接合表面152,该螺纹接合表面152设置成螺纹接收于外部环形保持套筒74中。内部环形保持套筒72可以包括具有叉形抵靠元件154的近端。叉形抵靠元件154可以包括一对间隔的尖头156,该对尖头156设置成以上述方式抵靠内部芯50。因此,线62可以在尖头156之间延伸穿过各联接件28的内部芯50,并穿过内部环形保持套筒72。延伸穿过内部环形保持套筒的线的自由端可以与任意合适的拉紧装置连接,该拉紧装置设置成施加足以使得椎间植入体20膨胀的偏压力。
下面参考图18A-B,插入工具70还可以包括角形元件158,该角形元件158连接于联接装置26的前端127以及内部和外部保持套筒72和74的近端之间。角形元件158可以包括:矩形块159;圆柱形体160,该圆柱形体160刚性附接在块159中;以及孔162,该孔162穿过圆柱形体160延伸,其尺寸设置成接收线66。因此,线66可以延伸穿过联接装置56、圆柱形体160和内部套筒72。外部套筒73可以限定纵向贯穿延伸的孔164以及穿过该孔164延伸的定向杆166。定向杆166限定了在连接位置158处与块159可枢轴转动地连接的近端,该连接位置158相对于圆柱形体160的侧向中心侧向偏移。
在操作过程中,矩形块159抵靠内部芯50,且定向杆166可以纵向前后运动,从而使得圆柱形体160相对于内部和外部套筒72和74的近端旋转。当圆柱形体160旋转时,矩形块159使得椎间植入体改变它在由侧向和纵向方向限定的水平平面中的角度方位。如图所示,杆166沿向前方向的运动使得椎间植入体20沿顺时针方向枢转,而杆166沿向后方向的运动使得植入体沿逆时针方向枢转。当然,应当知道,杆166也可以选择在这样的位置与矩形块159连接,即当杆向后运动时使得椎间植入体20沿顺时针方向枢转,而当杆向前运动时逆时针方向枢转。
在操作过程中,杆166的纵向位置可以在将椎间植入体20插入椎间盘空间22内之前确定,以便限定植入体20相对于内部和外部套筒72和74的角度方位。植入体20的角度方位使得植入体能够沿前-后方向路径或后-前方向路径插入体腔内,同时使得植入体定向成使得当该植入体插入椎间盘空间22中时,纵向轴线L相对于前面方向和后面方向限定了所需角度。一旦椎间植入体20插入椎间盘空间22中时,线66可以纵向向前运动,以便使得植入体20单独沿横向方向T膨胀,或者沿横向方向T和同时沿侧向方向A膨胀。而且,当植入体20单独沿横向方向T膨胀,或者沿横向方向T和同时沿侧向方向A膨胀时,相对横向椎骨接合表面32可以保持平坦和相互平行,或者可以限定一定角度方位,该角度方位设置成以上述方式使得椎骨24恢复脊柱前凸。
最后,参考图19A和19B,一旦植入体20位于椎间空间22中并膨胀至所需的膨胀位置,外部套筒72可以与椎间植入体脱开,且工具70的其余部分可以通过沿切割线168(该切割线168沿侧向-横向平面LT)切割椎间体50的、从联接装置26的前端127凸出的部分而除去。切割可以使用例如在相对位置的往复运动刀片而从相对方向来进行,使得刀片可以切穿内部芯本体52和线66,并使得本体50环绕金属线66卷曲。也可选择,内部芯本体52可以以任意所需方式来切割,且在本体50和线66被切割之后单独的卷曲工具可以用于使得本体50环绕线66卷曲,从而在外科手术过程结束后固定线和防止线66意外脱出。
上面结合示例实施例所述的实施例通过示例说明,因此本发明并不局限于所述实施例。而且,上述各实施例的结构和特征可以用于这里所述的其它实施例。因此,本领域技术人员应当知道,本发明将包括所有包含在由附加权利要求提出的本发明精神和范围内的变化和可选结构。
Claims (20)
1.一种可膨胀的椎间植入体,所述可膨胀的椎间植入体能够插入椎间盘空间中并能够从初始位置膨胀至膨胀位置,所述可膨胀的椎间植入体包括:
联接装置,所述联接装置包括沿纵向方向连接的多个联接件,每个联接件都包括:
外部套筒,所述外部套筒包括第一外部套筒部分和能够相对于所述第一外部套筒部分运动的第二外部套筒部分,其中,所述第二外部套筒部分限定第一接合表面,所述第一接合表面相对于所述纵向方向倾斜;
内部芯,所述内部芯布置在所述第一外部套筒部分和第二外部套筒部分之间,所述内部芯限定第二接合表面,所述第二接合表面相对于所述纵向方向倾斜并抵靠所述第一接合表面;
其中,在所述内部芯和所述第二外部套筒部分之间沿所述纵向方向的相对运动使得所述第一接合表面沿所述第二接合表面行进,从而使得所述第二外部套筒部分沿与所述纵向方向基本垂直的方向偏转离开所述第一外部套筒部分。
2.根据权利要求1所述的可膨胀的椎间植入体,其中:所述外部套筒和所述内部芯限定接合元件,所述接合元件在所述外部套筒部分膨胀至所述膨胀位置后互锁,从而防止所述外部套筒部分朝向彼此收缩。
3.根据权利要求2所述的可膨胀的椎间植入体,其中:所述接合元件包括多个凸起,所述凸起从所述第一接合表面和第二接合表面朝向彼此延伸,所述凸起在彼此上面进行凸轮运动,从而使得所述第二外部套筒部分递增地偏转离开所述第一外部套筒部分。
4.根据权利要求3所述的可膨胀的椎间植入体,其中:所述凸起包括反向角度齿。
5.根据权利要求1所述的可膨胀的椎间植入体,其中:所述第一接合部分和第二接合部分相对于所述纵向方向形成竖直角度,使得所述第二外部套筒部分相对于所述第一外部套筒部分竖直地膨胀。
6.根据权利要求1所述的可膨胀的椎间植入体,其中:所述第二外部套筒部分限定第三接合表面,所述内部芯限定抵靠所述第三接合表面的第四接合表面,所述第三接合表面和所述第四接合表面限定相对于水平方向的侧向角度,从而在所述内部芯和所述外部套筒部分之间的相对运动使得所述第二外部套筒部分相对于所述第一外部套筒部分侧向膨胀。
7.根据权利要求1所述的可膨胀的椎间植入体,其中:所述联接件中的一个联接件的第二外部套筒部分的第一接合表面相对于所述纵向方向以第一角度倾斜,所述联接件中的另一联接件的第二外部套筒部分的第一接合表面相对于所述纵向方向以第二角度倾斜,所述第一角度与所述第二角度不同。
8.根据权利要求7所述的可膨胀的椎间植入体,其中:各联接件限定相对的椎骨接合表面,所述椎骨接合表面相对于所述纵向方向以一定角度延伸,各联接件的椎骨接合表面的角度与其它联接件的椎骨接合表面的角度不同。
9.根据权利要求7所述的可膨胀的椎间植入体,其中:各联接件限定相对的椎骨接合表面,所述椎骨接合表面相对于所述纵向方向倾斜,各联接件的椎骨接合表面相互对齐并且彼此平行地延伸。
10.根据权利要求1所述的可膨胀的椎间植入体,还包括:偏压元件,所述偏压元件与所述内部芯元件接合;以及支杆元件,所述支杆元件与所述外部套筒部分接合,使得所述偏压元件能够相对于所述支杆元件运动,从而使所述内部芯元件相对于所述外部套筒部分运动。
11.根据权利要求1所述的可膨胀的椎间植入体,其中:所述多个联接件中的相邻联接件在连接位置处连接,所述可膨胀的椎间植入体还包括保持器环带,所述保持器环带布置在连接位置,从而向连接的联接件施加压紧保持力。
12.根据权利要求1所述的可膨胀的椎间植入体,其中:所述第一外部套筒部分限定第三接合表面,所述内部芯元件限定抵靠所述第三接合表面的第四接合表面,从而在所述内部芯和所述第一外部套筒部分之间沿所述纵向方向的相对运动使得所述第三接合表面沿所述第四接合表面行进,由此使所述第一外部套筒部分偏转离开所述第二外部套筒部分。
13.根据权利要求12所述的可膨胀的椎间植入体,其中:所述第一接合表面和所述第二接合表面相互平行,所述第三接合表面和所述第四接合表面相互平行。
14.根据权利要求1所述的可膨胀的椎间植入体,其中:所述联接件成一体且刚性地彼此连接。
15.一种可膨胀的椎间植入体,所述可膨胀的椎间植入体用于插入椎间盘空间中并能够从初始位置膨胀至膨胀位置,所述可膨胀的椎间植入体包括:
外部套筒,所述外部套筒沿纵向方向延伸,所述外部套筒包括第一外部套筒部分和第二外部套筒部分,所述第二外部套筒部分能够相对于所述第一外部套筒部分沿与所述纵向方向基本垂直的横向方向运动,其中,所述第一外部套筒部分和所述第二外部套筒部分各自限定相对于所述纵向方向倾斜的接合表面;以及
内部芯,所述内部芯布置在所述外部套筒部分之间,所述内部芯限定一对接合表面,所述内部芯的一对接合表面分别与所述第一外部套筒部分和所述第二外部套筒部分的所述接合表面配合,从而在所述内部芯和所述外部套筒之间沿所述纵向方向的相对运动使得所述第一外部套筒部分和所述第二外部套筒部分沿所述内部芯的所述接合表面远离彼此地偏转。
16.根据权利要求1所述的可膨胀的椎间植入体,其中:所述外部套筒的所述接合表面包括接合元件,所述内部芯的所述接合表面还包括接合元件,所述外部套筒的所述接合元件与所述内部芯的所述接合元件配合,从而防止所述第一外部套筒部分和所述第二外部套筒部分朝向彼此收缩。
17.根据权利要求16所述的可膨胀的椎间植入体,其中:所述接合元件包括从所述接合表面凸出的纵向间隔的齿。
18.根据权利要求17所述的可膨胀的椎间植入体,其中:互锁的齿是反向角度齿。
19.根据权利要求15所述的可膨胀的椎间植入体,还包括:偏压元件,所述偏压元件延伸穿过所述内部芯并与所述内部芯连接;以及支杆,所述支杆与所述外部套筒接合,其中,所述偏压元件向所述内部芯施加纵向方向的力,所述力使得所述内部芯相对于所述外部套筒沿纵向运动。
20.可膨胀的椎间植入体的成套工具,该成套工具包括:
外部套筒元件,所述外部套筒元件沿纵向方向延伸并限定外部椎骨接合表面和相对于所述外部椎骨接合表面竖直布置的内部接合表面,所述内部接合表面相对于所述纵向方向倾斜,其中,所述外部套筒元件布置在第一竖直位置;
内部芯,所述内部芯具有接合表面,所述内部芯的接合表面相对于所述纵向方向倾斜,其中,所述内部芯的所述接合表面与所述外部套筒元件的所述内部接合表面配合,从而所述内部芯相对于所述外部套筒元件的相对运动使得所述外部套筒元件沿所述内部芯的所述接合表面行进并偏转至不同于所述第一竖直位置的第二竖直位置。
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