CN102481161A - 带有干涉配合紧固件的植入物 - Google Patents

带有干涉配合紧固件的植入物 Download PDF

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CN102481161A
CN102481161A CN2010800382576A CN201080038257A CN102481161A CN 102481161 A CN102481161 A CN 102481161A CN 2010800382576 A CN2010800382576 A CN 2010800382576A CN 201080038257 A CN201080038257 A CN 201080038257A CN 102481161 A CN102481161 A CN 102481161A
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section
securing member
passage
implant
diameter
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A·J·麦尔肯特
T·A·卡利斯
L·G·沃戈
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Warsaw Orthopedic Inc
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Warsaw Orthopedic Inc
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    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
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Abstract

本发明公开了一种植入物,该植入物带有用于将植入物附接至骨的干涉配合紧固件。干涉配合防止在附接之后紧固件退出。植入物可以包括具有第一端部和第二端部的通道。通道在第一端部和第二端部之间可以包括第一干涉段。呈细长形状的紧固件可以具有延伸贯穿通道以将植入物附接至骨的尺寸。紧固件可以包括第二干涉段。在紧固件插入通过通道且进入骨期间,紧固件的第二干涉段可以与通道的第一干涉段抵靠接触,并且发生变化或者通过第一干涉段而发生变化。该变化可以在植入物和紧固件之间产生防止退出的干涉配合。一旦紧固件与骨完全附接,干涉段可以保持接触或者可以移开。

Description

带有干涉配合紧固件的植入物
技术领域
本申请涉及通过紧固件与骨附接的植入物,并且更具体地,涉及具有不同硬度的紧固件和植入物,在将紧固件插入穿过植入物中的通道时紧固件和植入物中的一个发生变化以产生干涉配合。
背景技术
各种类型的植入物被插入患者体内,并且通过紧固件与骨附接。紧固件延伸贯穿植入物并且进入骨,从而使植入物保持靠着骨。紧固件还可以构造成对植入物施加压力。植入物和紧固件的结构应防止紧固件松开,否则会从骨和/或植入物移去。紧固件相对于骨和/或植入物的该后退移动被称为退出。退出可以因附接植入物之后骨下沉、或者紧固件从骨上松开而引起。
已开发了用于防止紧固件退出的机构。一种类型的机构包括附接至植入物并且延伸过贯穿植入物的通道的扣环,其中通道用于接收紧固件。在紧固件插入期间触碰扣环,使扣环远离通道移动以允许插入。一旦紧固件通过,扣环回弹到通道和紧固件的头部的上面。这些机构的缺点包括:扣环可能会脱离植入物,并且扣环可能不会回弹到紧固件的上面。进一步地,在外科手术过程中,外科医生在确定扣环的位置方面会有困难。
另一种机构包括在锁定取向与解锁取向之间可被外科医生移动的凸出件,其中锁定取向延伸在植入物中的通道的上面,而解锁取向远离通道。当紧固件被插入通道并且被驱动进入骨时,凸出件处于解锁取向。在插入之后,外科医生将凸出件移动至在通道和所述紧固件的近侧端部的上面的锁定取向。该设计的缺点是,它需要外科医生在插入紧固件之后进行附加的步骤。对外科医生而言,还难以确定凸出件是否被适当地定位在紧固件的上面。
发明内容
本申请是附接至骨的植入物以及使用植入物的方法。植入物可以包括具有第一端部和第二端部的通道。通道在第一端部和第二端部之间可以包括第一干涉段。呈细长形状的紧固件可以具有延伸贯穿通道以将植入物附接至骨的尺寸。紧固件可以包括第二干涉段。在紧固件插入通过通道且进入骨期间,紧固件的第二干涉段可以与通道的第一干涉段抵靠接触,并且发生变化或者通过第一干涉段而发生变化。该变化可以在植入物和紧固件之间产生防止退出的干涉配合。一旦紧固件与骨完全附接,第一和第二干涉段可以保持接触,或者可以移开。
各个实施方式的各个方面视需要可以单独或者以任何组合方式使用。
附图说明
图1是根据本申请的一个实施方式的定位在骨处的紧固件和植入物的示意性透视图。
图2是根据一个实施方式的定位在贯穿植入物的通道中的紧固件的透视图。
图3是沿图2的线III-III切下的剖视图。
图4是根据一个实施方式的植入物的透视图。
图5是沿图4的线V-V切下的剖视图。
图6是根据一个实施方式的定位在贯穿植入物的通道中的紧固件的透视图。
图7是沿图6的线VII-VII切下的剖视图。
图8是根据一个实施方式的贯穿植入物的通道的剖视图。
图9是根据一个实施方式的贯穿植入物的通道的剖视图。
图10是根据一个实施方式的贯穿植入物的通道的剖视图。
图11是根据一个实施方式的贯穿植入物的通道的剖视图。
图12是根据一个实施方式的紧固件的侧视图。
图13是图12的紧固件的侧视示意图。
图14是根据一个实施方式的插入骨中第一段距离的紧固件的剖视图。
图15是根据一个实施方式的插入骨中第二段距离的紧固件的剖视图。
图16是根据一个实施方式的插入骨中第三段距离的紧固件的剖视图。
图17是根据一个实施方式的紧固件的剖视图。
图18是根据一个实施方式的插入骨中第一段距离的紧固件的剖视图。
图19是根据一个实施方式的插入骨中第二段距离的紧固件的剖视图。
图20是根据一个实施方式的插入骨中第三段距离的紧固件的剖视图。
图21是根据一个实施方式的紧固件的侧视图。
图22是根据一个实施方式的紧固件的侧视图。
图23是根据一个实施方式的紧固件的侧视图。
图24是根据一个实施方式的紧固件的侧视图。
图25是根据一个实施方式的与植入物附接的插入件的剖视图。
图26是根据一个实施方式的涂覆于植入物上的涂层的剖视图。
具体实施方式
本申请涉及带有自锁式骨紧固件的植入物,其中该自锁式骨紧固件将植入物附接至骨上。该植入物包括用于接收该紧固件的通道。该植入物和该紧固件的侧壁包括不同的硬度,致使当紧固件插入植入物时其中一个将发生变化。变化使紧固件和植入物之间产生干涉配合,以防止所述紧固件退出。
图1示意性示出紧固件20,紧固件20具有配合在植入物30的通道40中的尺寸。紧固件20用于延伸穿过通道40并且将植入物30附接至骨100上。紧固件20包括直径比通道40的干涉段70大的干涉段72。紧固件20还由硬度不同于干涉段70的材料构成。当紧固件20进入通道40时,干涉段70、72中的一个发生变化,并且产生干涉配合。该干涉配合至少防止紧固件20在植入物30附接之后退出骨100。
通过一个或者多个紧固件20将植入物30附接至骨100上,植入物30可以包括各种形状和构造。图2和图3包括植入物30,该植入物被构造成定位在形成于椎骨构件之间的椎间空间内的间隔件。植入物30包括上表面31和下表面32,其中上表面31被构造成与第一椎骨构件抵靠接触,下表面32被构造成与第二椎骨构件抵靠接触。齿39可以从表面31、32中的一个或者两个向外延伸,以方便插入椎间空间中和/或维持在椎间空间中的位置。侧壁33在表面31和表面32之间延伸。在表面31和表面32之间测得的间隔件的高度可以是不变的,或者如图3最佳地示出可以是变化的,即高度从第一横向侧壁61至第二横向侧壁62增加。中央通道63可以延伸贯穿间隔件并且贯穿表面31、32。
如图4和图5所示,植入物30还可以包括人工椎间盘。植入物30包括第一构件64和第二构件65,第一构件64和第二构件65构造成定位在椎间空间中,其中椎间空间形成于椎骨构件之间。第一构件64包括构造成与第一椎骨构件抵靠接触的上表面31,并且下表面32形成在第二构件65上且与第二椎骨构件抵靠接触。第一构件64还包括凸起段34,凸起段34向外延伸并且与第二构件65中的凹入段35匹配。凸起段34和凹入段35形成球铰布置,该球铰布置形成人工椎间盘。凸缘36定位在构件64、65上,并且包括通道40,每个通道40具有接收紧固件20的尺寸。凸缘36和通道40中的每一个都可以包括不同的形状、尺寸和取向,或者如图4最佳地示出,凸缘36和通道40中的每一个都可以是基本相同的。当凸起段34和凹入段35定位在椎间空间中时,通道40与第一椎骨构件和第二椎骨构件的外部对齐。在另一个实施方式中,植入物30不包括凸缘36,并且通道40以如图2和图3所示的相似方式直接延伸贯穿第一构件64和第二构件65。
植入物30还可以包括如图6和图7所示的板。该板包括第一表面31和第二表面32,其中第一表面31背离骨100,第二表面32面向骨100且与骨100抵靠接触。侧壁33在第一表面31和第二表面32之间延伸。该板可以是基本平的或者可以是弯曲的。在表面31、32之间测得的厚度在整个板上可以是相同的,或者可以是变化的。一个或者多个通道40从第一表面31至第二表面32延伸贯穿该板。一个或者多个通道40还可以定位成至少部分地贯穿侧壁33。
植入物30由硬度不同于紧固件20的材料构成。该不同导致:植入物30在插入期间使紧固件20发生变化或者通过紧固件20而发生变化,并且产生防止紧固件20退出的干涉配合。植入物材料包括但不局限于聚芳醚酮(PAEK)、聚醚醚酮(PEEK)、碳纤维增强PEEK,聚醚酮酮(PEKK)、聚砜、聚醚酰亚胺、聚酰亚胺、超高分子量聚乙烯(UHMWPE)、塑料、钛、钛合金、不锈钢、和金属合金。
通道40延伸贯穿植入物30,以用于接收紧固件20。如图8所示,通道40一般包括第一端部41和第二端部42,具有沿着轴线C在第一端部41和第二端部42之间而测得的长度L。通道40还包括在端部41、42之间延伸的侧壁43。直径W为在侧壁43之间横穿通道40而测得。直径W可以沿着长度L而变化。图8包括在第一端部41处比在第二端部42处宽的直径W。在第一端部41处的较宽直径W形成了如图2和图3中所示的用于使紧固件20的头部25在通道40内坐落的容置部(receptacle)。图9包括具有沿着整个长度L不变的直径W的另一个通道40。
通道40可以以各种取向延伸贯穿植入物30。图2和图3包括相对于上表面31和下表面32成角度(即,轴线与表面31、32既不平行也不垂直)的通道40。第一端部41延伸贯穿上表面31和侧壁33,第二端部42延伸贯穿下表面32。相对于上表面31和下表面32的角度的大小可以根据使用环境而变化。其它如图9所示的构造包括使通道40的第一端部41孤立地仅仅位于侧壁33上的成角度的取向。图4至图7包括在相对表面之间更直接地延伸贯穿植入物30的通道40。
通道40包括在插入期间与紧固件20相互作用的干涉段70。在如图8所示的一个实施方式中,干涉段70包括比直径W窄的直径W’。干涉段70可以包括不同形状和长度。图8包括沿着长度L的有限距离(具体为接近第二表面32)延伸的干涉段70。由于直径W沿着长度L是不变的(即,W等于W’),因此图9包括沿着通道40的整个长度L延伸的干涉段70。
干涉段70可以关于轴线C对称。图8和图9均包括对称的干涉段70。干涉段70还可以包括其它各种构造。图10包括在形成干涉段70的侧壁43之一上的延伸部。通道40还可以包括多个干涉段70。图11包括三个干涉段70a、70b、70c。多个段70均可以包括相同或者不同的形状和/或直径W’。
干涉段70包括与紧固件20接合的坚实表面。在一个实施方式中,植入物30包括单一整体式构造。因此,干涉段70由与植入物30的剩余部分相同的材料且相同的单一结构构成。在如图25所示的另一个实施方式中,干涉段70由附接至植入物30的插入件80形成。插入件80形成通道40和干涉段70。可以以各种方式将插入件70附接至植入物30,包括但不局限于干涉配合、螺纹配合、机械紧固件、以及粘合剂。如图26所示,另一个实施方式包括涂覆于通道40的侧壁43上的涂层81。涂层81减小了通道40的宽度并且形成了干涉段70。
当沿着轴线C观看时,通道40可以包括圆形形状。然而,通道40还可以包括其它形状,这些形状包括但不局限于卵形、矩形、方形、和椭圆形。术语直径用于限定在侧壁43之间跨过通道40的距离并且应解释为还适用于非圆形的通道。
紧固件20用于延伸贯穿通道40并且将植入物30附接至骨100。紧固件20可以包括各种形状和构造以实现该作用。紧固件20可以由各种材料构成,包括但不局限于钛、钛合金、不锈钢、金属合金、聚芳醚酮(PAEK)、聚醚醚酮(PEEK)、碳纤维增强PEEK、聚醚酮酮(PEKK)、聚砜、聚醚酰亚胺、聚酰亚胺、超高分子量聚乙烯(UHMWPE)、以及塑料。
图12示出沿着纵向轴线L延伸的呈细长形状的紧固件20,紧固件20通常包括杆部22和头部25。紧固件20包括位于杆部22的端部处的远侧末端23和位于头部25处的相对近侧端部24。远侧末端23优选地渐缩为点,以方便移动贯穿骨100,然而末端23可以包括其它非渐缩形的构造。主体20在末端23和端部24之间测得的长度可以改变。
紧固件20可以包括围绕纵向轴线缠绕且沿着杆部22和/或头部25延伸的一个或者多个螺旋状螺纹21。螺纹21可以沿着紧固件20的整个长度或者仅沿着有限长度延伸。螺纹21限定了靠近纵向轴线L的根部28和远离纵向轴线L的顶部29。紧固件20包括在根部28之间测得的较小直径di和在顶部29之间测得的较大直径do。直径di和do中的一个或者两个沿着紧固件20的长度可以是不变的或者可以是变化的。
顶部29可以是渐缩形的以方便自攻丝,或者可以是切去顶端且基本上为平的。顶部29沿着螺纹21的长度可以是不变的或者可以是变化的。螺纹21包括从根部28至顶部29测得的深度。图12包括沿着杆部22的长度一致的螺纹深度。根据需要,深度也可以沿着长度而变化。螺纹21沿着长度还可以包括相同或者不同的角度和/或螺距。图12包括沿着螺纹21的长度相同的螺纹角度和螺距。
容置部26可以延伸进入头部25,以接收用于对紧固件20施加扭矩的工具。容置部26可以包括各种形状,以接收各种驱动类型的工具,这些驱动类型包括但不局限于一字、十字(Phillips)、六角、梅花(Torx)、键槽驱动(spline drive)、以及双头六角(double hex)。
头部25的横截面形状也可以变化,包括但不局限于圆扁头(pan head)、半圆头(button)、圆头(round)、埋头(countersunk)、以及色拉头(oval)。头部25还可以包括与杆部22相同的尺寸和形状。杆部22的横截面形状可以是圆形的或者还可以是其它形状。术语直径被再次使用且适于这些不同的形状。
一个或者多个自攻凹槽27可以定位在远侧末端23处。凹槽27不带螺纹且延伸进入杆部22以方便贯穿骨100的插入和移动。
紧固件20还包括沿着长度的纵向段延伸的干涉段72。干涉段72包括比通道40的干涉段70的直径W’大的直径。该尺寸上的差导致:干涉段72与干涉段70抵靠接触、并且干涉段72使干涉段70发生变化或者干涉段70使干涉段72发生变化,以在紧固件20和植入物30之间产生干涉配合。在一个实施方式中,仅螺纹21产生干涉段72。其它实施方式包括形成干涉段72的杆部22的中央主体。干涉段72的沿着纵向轴线L测得的长度L可以变化。
图13示出图12的螺钉的理论侧视图。沿着杆部22延伸的虚线表示由根部28限定的较小直径di,实线29表示由顶部29限定的较大直径do。图13示出顶部29的实线平行于根部28的虚线,这样,螺纹厚度沿着杆部22的长度是相同的。
紧固件20包括均沿着纵向轴线L的长度延伸的一个或者多个纵向段50。段50可以包括不变或者变化的直径di、do。第一段51从远侧末端23向内延伸。图13的紧固件包括呈渐缩形状且在远离末端23的近侧方向上变宽的第一段51。螺纹21可以沿着第一段51延伸或者可以不沿着第一段51延伸。在一个实施方式中,螺纹21顺着第一段51开始。第二段52和第四段54沿着杆部22定位并且均包括朝向紧固件20的近侧端部增加的渐缩形状。锥度可以是相同的或者可以是不同的。段52、54均包括线性锥度。锥度还可以是非线性的(即,弯曲锥度)。图13示出第四段54比第二段52具有更明显的锥度。第三段53和第五段55沿着它们的长度均包括不变的直径di、do。
在该实施方式中,干涉段72由图13的紧固件20中的第四段54的一部分和第五段55形成。定位干涉段72的起始边缘73(即,远侧边缘)方便于使干涉段70、72中的一个发生变化。
图14至图16示出利用紧固件20将植入物30附接至骨100的步骤。该实施方式中的通道40具有宽的第一端部41的特征,通道40向下渐缩并且通至干涉段70。如图14所示,通过通道40插入紧固件20,使远侧末端23与骨100抵靠接触。在该插入距离处,螺纹21与骨100接合但不与通道40的侧壁43抵靠接触。紧固件20的干涉段72被定位成远离通道40的干涉段70。
图15示出紧固件20被插入骨100中又一段距离。在插入的该点处,干涉段72处的螺纹21与干涉段70接触。在该实例中,植入物30由比紧固件20软的材料构成。侧壁43是坚实的、相当光滑的且未预先攻丝。当紧固件20旋转并移动贯穿通道40时,干涉段72使干涉段70发生变化并且产生干涉配合。干涉段72可以在其切削侧壁43时进行自攻丝,或者可以在它使侧壁43变形时形成螺纹。干涉段72远离头部25一定距离,以便在头部25于通道40中降至最低点之前发生变化。
图16示出完全插入骨100中的紧固件20。通过头部25抵靠接触通道40来控制插入的距离。在该实施方式中,头部25和通道40被构造成:头部25配合并且凹进在通道40内。干涉段72保持与干涉段70接合,其中该接触形成了干涉配合以防止紧固件20退出。
图14至图16的实施方式也可以使用由比植入物30软的材料构成的紧固件20。当紧固件20移动通过通道40时,干涉段70使紧固件20的干涉段72发生变化。这可以包括在螺纹21移动通过干涉段70时仅螺纹21发生变化,或者还可以包括杆部22的主体的变化。
图17包括带有第一纵向段51、第二螺纹纵向段52和第三纵向段53的紧固件20,其中第一纵向段51包括远侧末端23,第一纵向段51、第二螺纹纵向段52和第三纵向段53均远离头部25而定位。第二纵向段52包括直径di、do朝向近侧端部变大的逐步渐缩形状。干涉段72定位在第二段52的近侧端部处。螺纹21沿着段52的长度延伸。段57定位在干涉段72和头部25的远侧端部之间。纵向段57不带螺纹并且包括比干涉段72的较大直径do小的直径dm。
图18至图20示出利用该紧固件20将植入物30附接至骨100的步骤。这些步骤包括由比植入物30硬的材料构成的紧固件20。图18包括将紧固件20插入第一段距离,使第一段51以及第二段52的一部分延伸进入骨100。第二段52在通道40中的这部分的直径比通道40小,使螺纹21与侧壁43间隔开。
图19示出紧固件20插入骨100更大距离。在插入的该点处,干涉段72与干涉段70抵靠接触并且使干涉段70发生变化。侧壁43是坚实的且未预先攻丝。干涉段72与头部25间隔一段距离,以在头部25坐入植入物30之前使干涉段70发生变化。
图20示出紧固件20完全插入骨100。头部25在通道40中降至最低并且与侧壁43接触。进一步地,干涉段72移动越过干涉段70。在该实施方式中,干涉段72移动越过通道40的第二端部42并且进入骨100。由于螺纹21不再与干涉段70中形成的轮廓对齐,因此可以防止紧固件20退出骨100。因此,当干涉段72上的螺纹21与植入物30抵靠接触时,可以防止任何潜在的退出骨100的移动。图20还示出纵向段57不与侧壁43抵靠接触。在与图20相似的布置中,紧固件20可以构造成使得:干涉段72可以纵向移动越过干涉段70但仍然在通道40中。
图18至图20的实施方式也可以利用由比紧固件20硬的材料构成的植入物30进行实施。紧固件20在它插入通过通道40时发生变化。干涉段72通过与干涉段70接触而发生变化。
紧固件20可以包括与干涉段70相互作用并将植入物30附接至骨100的其它构造。图21包括具有第一螺纹21a、第二螺纹21b的紧固件20,其中第一螺纹21a沿着第一段51延伸,第二螺纹21b沿着第二段52和第三段53延伸。螺纹21a、21b可以包括一个或者多个不同的方面,包括外径、螺纹角和螺距。干涉段72由第二段52的一部分和第三段53形成。在该实施方式中,第一螺纹21a构造成与骨100附接,第二螺纹21b构造成与干涉段70接合、并使干涉段70发生变化,或者通过干涉段70而发生变化。紧固件20还可以包括多于两个的不同的螺纹21。多个螺纹的紧固件20的实例已在公开号为US 2007/0233122的美国专利公开中公开,在本文中通过参考引入其全部内容。
干涉段72还可以沿着紧固件20的不带螺纹的段形成。图22包括带有第一段51、螺纹第二段52以及不带螺纹的第三段53和第四段54的紧固件20。干涉段72由第四段54形成,其中远侧边缘形成在第三段53与第四段54的相交处。图23包括干涉段72由第二段52形成的紧固件20。一组接合特征74定位在第二段52中。接合特征74可以包括在杆部22的主体中开设的槽。槽可以是纵向的、径向的,或者螺旋的。接合特征74还可以包括从杆部22的主体的表面向外延伸的凸起件。接合特征74方便与干涉段70的接合和/或抑制可能导致紧固件20退出的进一步旋转。在类似的实施方式中,一个或者多个凹槽27靠近干涉段72而定位。
紧固件20还可以包括沿着长度定位的多个变化段72。图24包括带有第一干涉段72a和第二干涉段72b的实施方式,其中第一干涉段72a沿着第二段52而定位,第二干涉段72b沿着第四段54而定位。第一干涉段72a包括螺纹21并且具有在初始时会发生变化或者通过干涉段70而变化的尺寸。第二干涉段72b靠近第一干涉段72a而定位。第二干涉段72b也具有与干涉段70抵靠接触的尺寸。在该实例中,第二干涉段72b包括比第一干涉段72a大的直径。
在紧固件20插入通道40期间,第一干涉段72a移动通过通道40,并且发生变化或者通过干涉段70而发生变化。紧固件20的进一步插入使第二干涉段72b移动进入干涉段70,并且导致进一步的变化。紧固件20可以包括双重干涉配合的尺寸,使第一干涉段72a移动越过干涉段70,并且发生变化或者通过干涉段70而发生变化以防止退出。第二干涉段72b可以保持在干涉段70中并且形成第二干涉配合。紧固件20还可以包括多于两个的分离的变化段72。
用于将植入物30附接至骨100的各种紧固件20可以包括不同结构。上述紧固件20包括这些结构的不同组合。各种干涉段70、锥度、纵向段50、直径di、do、螺纹21、头部25、末端23、容置部26等根据使用环境在紧固件20中可以有各种不同组合,并且均包括在本申请的范围内。
干涉段70、72中的一个的变化产生防止退回的干涉配合。变化可以包括在较软的干涉段70、72上切削材料以形成螺纹的自攻丝接合。变化还可以包括通过较软的干涉段70、72的变形而引起的螺纹成形接合。变化还可以包括其它各种变形、切削以及以其它方式使较软干涉段70、72发生大致改变。通过段70、72之间的接合而引起的变化是永久的。
植入物10可以包括多于一个的通道40并且通过多于一个的紧固件20而附接至骨100。在这些实施方式中,通道40中的至少一个包括干涉段70,其中紧固件20使干涉段70发生变化。其它通道40可以包括干涉段70或者可以不包括干涉段70。进一步地,对于带有多个通道40的植入物30而言,通道40中的每一个均可以包括相同或者不同的结构。同样地,紧固件20均可以是相同的,或者一个或者多个紧固件20可以是不同的。
植入物30可以附接至患者体内的各种不同的骨100。这些包括患者的椎骨以及长骨。
在一个实施方式中,植入物30由PEEK构成,紧固件20由钛构成。通道30的侧壁43是坚实的且不带螺纹。
可以将植入物30植入有生命的患者,以治疗各种脊髓异常。植入物30还可以植入无生命情形中,例如在尸体、模型等中。无生命情形可适于测试、训练和展示目的中的一个或者多个。
为便于描述,使用诸如“在……之下”、“在……下面”、“较低的”、“在……之上”、“上面的”等空间相关术语来解释一个元素相对于第二元素的定位。除与图中所示的那些不同的取向之外,这些术语还意欲包含装置的不同取向。进一步地,还使用诸如“第一”、“第二”等术语来描述各元素、区域、段等,并且不是限定性的。在整篇说明书中,同样的术语指同样的元素。
如在本文中使用的,术语“具有”、“包含”、“包括”等是开放式术语,表明所述元素或者特征的出现,但不排除其它元素和特征。冠词意欲包括复数以及单数,除非上下文另有明确说明。
在不背离本发明的范围和本质特性的情况下,可以以与本文中提出的那些不同的其它具体方式来实施本发明。因此,出现的实施方式在所有方面被认为是示例性的而不是限制性的,并且在所附权利要求的含义和等同范围内的所有变化均包含在本文中。

Claims (19)

1.一种用于治疗患者的医疗装置,其包括:
植入物;
坚实且不带螺纹的通道,所述通道延伸贯穿所述植入物并且包括具有第一直径的第一干涉段;
紧固件,所述紧固件呈细长形状并且具有远侧端部和近侧端部,所述紧固件包括第二干涉段,所述第二干涉段位于所述端部之间并且包括比所述第一直径大的第二直径;
所述第一干涉段和第二干涉段中的一个由较硬材料构成,另一个由较软材料构成;
通过将所述紧固件插入所述通道使由较软材料构成的干涉段的表面发生变化,从而在所述植入物和所述紧固件之间产生干涉配合。
2.根据权利要求1所述的装置,其中所述第二干涉段是不带螺纹的。
3.根据权利要求1所述的装置,其中所述通道中的至少一部分是渐缩的。
4.一种用于治疗患者的医疗装置,其包括:
植入物;
通道,所述通道延伸贯穿所述植入物并且包括具有坚实且不带螺纹的侧壁的干涉段,所述干涉段包括第一直径;
紧固件,所述紧固件呈细长形状并且具有远侧端部和近侧端部,所述紧固件包括变化段,所述变化段位于所述端部之间并且包括比所述第一直径大的第二直径;
所述紧固件由比所述植入物硬的材料构成,在将所述紧固件插入所述通道期间所述变化段使所述干涉段发生变化,从而在所述植入物和所述紧固件之间产生干涉配合。
5.根据权利要求4所述的装置,其中所述变化段包括螺纹。
6.根据权利要求4所述的装置,其中所述干涉段由通过所述变化段而发生永久变化的材料构成。
7.根据权利要求4所述的装置,其中所述变化段包括从远侧部分朝向近侧部分增加的渐缩直径。
8.根据权利要求4所述的装置,其还包括远离所述变化段纵向间隔开的第二变化段,所述第二变化段包括大于所述第一直径且不同于所述第二直径的第三直径。
9.根据权利要求4所述的装置,其中所述变化段包括延伸进入所述紧固件的外表面并且沿着所述紧固件的纵向轴线对齐的槽。
10.根据权利要求4所述的装置,其中所述紧固件包括头部和杆部,所述头部包括比所述杆部和所述第二直径大的头部直径,所述变化段远离所述头部且朝向所述远侧端部地间隔开。
11.根据权利要求10所述的装置,其中沿着所述紧固件的纵向轴线在所述头部的远侧边缘与所述变化段的近侧边缘之间测得的第一距离大于在所述通道的第一端部与第二端部之间测得的第二距离。
12.根据权利要求4所述的装置,其中所述植入物由PEEK构成。
13.一种用于治疗患者的医疗装置,其包括:
植入物;
紧固件,所述紧固件带有定位在杆部的端部处的头部,所述紧固件包括沿着所述杆部定位的变化段,变化段直径大于所述杆部的其余部分的直径且小于所述头部的直径;
通道,所述通道延伸贯穿所述植入物并且包括具有坚实且不带螺纹的侧壁的干涉段,干涉段直径小于所述变化段直径;
所述紧固件由比所述通道硬的材料构成;
沿着所述紧固件的纵向轴线在所述头部的远侧边缘与所述变化段的近侧边缘之间测得的第一距离大于沿着所述通道的纵向轴线在接收所述头部的接触表面与所述第二端部之间测得的第二距离。
14.根据权利要求13所述的装置,其中所述通道还包括位于所述第一端部处以用于接收所述头部的容置部,所述接触表面定位在所述容置部的底部处。
15.根据权利要求13所述的装置,其还包括沿着所述紧固件的第一纵向段延伸的第一螺纹和沿着所述紧固件的第二纵向段延伸的不同的第二螺纹。
16.根据权利要求13所述的装置,其中所述变化段从所述杆部的远侧端部和近侧端部向内定位。
17.根据权利要求13所述的装置,其中所述植入物包括第一侧和第二侧、以及在所述第一侧和第二侧之间延伸的侧壁,所述通道的第一端部定位在所述第一侧处,所述通道的第二端部定位在所述第二侧处。
18.根据权利要求13所述的装置,其还包括定位在所述坚实且不带螺纹的侧壁的上面的涂层。
19.一种用于治疗患者的医疗装置,其包括:
植入物;
通道,所述通道延伸贯穿所述植入物并且包括具有坚实且不带螺纹的侧壁的第一干涉段,所述第一干涉段包括第一直径;
紧固件,所述紧固件呈细长形状并且具有远侧端部和近侧端部,所述紧固件包括第二干涉段,所述第二干涉段位于所述端部之间并且包括比所述第一直径大的第二直径;
所述第一干涉段由比所述第二干涉段硬的材料构成,在将所述紧固件插入所述通道期间所述第二干涉段发生永久变化。
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US20150289912A1 (en) 2015-10-15
US9095444B2 (en) 2015-08-04
EP2456378B1 (en) 2013-11-06
EP2456378A1 (en) 2012-05-30
JP2013500084A (ja) 2013-01-07
JP5865244B2 (ja) 2016-02-17
WO2011011784A1 (en) 2011-01-27
AU2010275376A1 (en) 2012-02-23
US9433453B2 (en) 2016-09-06
CA2768669A1 (en) 2011-01-27
US20110022173A1 (en) 2011-01-27

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