CN104244871B - 模块化的分区段的髓核植入物 - Google Patents

模块化的分区段的髓核植入物 Download PDF

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Publication number
CN104244871B
CN104244871B CN201380013982.1A CN201380013982A CN104244871B CN 104244871 B CN104244871 B CN 104244871B CN 201380013982 A CN201380013982 A CN 201380013982A CN 104244871 B CN104244871 B CN 104244871B
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CN104244871A (zh
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杰弗利·C·菲尔特
马克·A·吕德尔
斯蒂芬·H·克罗斯宾
约翰·P·米哈维耶
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Vertebral Technologies Inc
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Vertebral Technologies Inc
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Abstract

本文提供分区段的髓核置换假体和用于其植入的系统，其中所述区段全部由顺应的、均质的材料制成。所述假体包括多个模块区段，所述多个模块区段以轨道‑和‑槽的布置方式配合在一起。所述轨道和槽被配置成：虽然由顺应的材料形成，但在负荷下互锁和保持在一起。在一个实施方案中，插入工具和稳定器用于操纵模块区段，所述插入工具和稳定器被设计成适应于操纵顺应的模块区段。

Description

模块化的分区段的髓核植入物
相关申请
本申请要求于2012年3月16日提交的美国临时申请号61/685,383的利益，所述申请的公开内容除了包含在其中的表达定义以外完整地结合于此。
背景
已知使用其中使用插入导引将各区段相继植入的分区段的脊椎植入物用于所谓的“最小侵入”手术技术。Beyar等的美国专利申请号2008/0133017(下文中“Beyar”)公开了二级的、保留运动的整体椎盘置换系统，所述系统使用二级区段，每个区段包括顶部“片”和底部“片”以构建两个级别的运动保留设备。
Felt等的美国专利号7,591,853(下文“Felt”)公开了分区段的髓核植入物，其包括由顺应的外壳包围的硬的内核。顺应的外壳有助于运动保留方面，而内核可以由较硬的材料如聚醚醚酮(PEEK)构造而成以有助于可靠地互锁各区段的结构。
一个与Felt的设备相似而与Beyar的设备不相似，仅置换髓核以提高减小的侵入性，并且还提高Felt的设备的运动保留特征的系统将是受欢迎的。
概述
本发明的不同的实施方案包括分区段的髓核假体，所述假体由(在整个假体中均匀地)单一顺应材料制成。与其他可获得的分区段的运动保留设备相比，顺应的材料提供更接近地模仿天然髓核的运动的髓核植入物。分区段的特征使得具有减小的侵入性的设备的植入成为可能，并且使得下面的模块设计成为可能，所述模块设计使得能够由模块区段“构件块”构建具有变化的尺寸的假体。
迄今，认为较硬材料的存在对于促进互锁是必要的。因此，Beyar和Felt的分区段的植入物包含这样的互锁结构，所述互锁结构包含硬的材料如金属和PEEK。这些硬材料的存在可能影响运动保留设备设计的复杂性，或者与天然髓核相比限制脊柱的运动。公开的发明与Beyar和Felt的不同之处在于互锁的模块区段不包括用于促进互锁特征的硬材料。相反地，本发明的不同的实施方案的互锁的模块区段由单一的顺应材料制成。此外，Beyar教导了整体椎盘置换而不是髓核置换，并且因此整体上比本发明侵入性更大。
在结构上，本发明的实施方案的不同方面涉及在虽然使用顺应材料的情况下使区段的肯定的互锁成为可能。在某些实施方案中，包括多个模块区段，其各自包括上方侧，下方侧，近端，和与近端相对的远端。上方和下方侧被布置在各个模块区段的横平面的相对的面上，当处于植入构型时所述横平面正交于各个模块区段的上/下坐标。在一些实施方案中，横平面对应于中心横平面。当处于植入构型时，多个模块区段中的每个适合于以并排的布置方式在横平面上与多个模块区段中的邻近的一个互锁。多个模块区段可以包括第一末端模块区段，所述第一末端模块区段包括第一末端体部和第一末端轨道部分，第一末端轨道部分延伸自第一末端体部的侧翼面，第一末端轨道部分限定第一末端轨道轴，所述第一末端轨道轴通过第一末端模块区段的近端和远端。第一末端轨道轴位于第一末端模块区段的横平面上。第一末端轨道部分包括多个完全相对的倒钩，所述倒钩相对于第一末端轨道轴在径向上向外地并且平行于第一末端模块区段的上/下坐标延伸，第一末端轨道部分具有垂直于第一末端轨道轴的第一末端轨道横截面。在一个实施方案中，第一末端轨道部分包括网状物和轨头，所述网状物被布置在轨头和侧翼面之间并且沿横平面延伸。所述轨头可以包括平坦平面，所述平坦平面以直角和锐角中的一个与所述网状物相交。
所述假体还可以包括相对的末端模块区段，所述相对的末端模块区段包括体部，所述体部限定具有内表面的相对的末端细长槽，相对的末端细长槽通过相对的末端模块区段的体部以限定相对的末端槽轴，相对的末端槽轴位于垂直于相对的末端模块区段的上/下坐标的横平面上。相对的末端模块区段的体部限定垂直于相对的末端槽轴的相对的末端体部横截面，相对的末端模块区段的体部还限定多个凹穴，所述多个凹穴从相对的末端细长槽的内表面凹进。多个凹穴中的每个可以相对于相对的末端槽轴在径向上向外地并且平行于相对的末端模块区段的上/下坐标延伸。
相对的末端模块区段的体部可以包括上唇部分和下唇部分，唇部分中的每个邻近相对的末端细长槽并且平行于相对的末端槽轴延伸并且各自向相对的末端模块区段的横平面突出。相对的末端模块区段的上唇部分和下唇部分中的每个可以限定与轨头的平坦平面互补的内面。在一个实施方案中，第一末端轨道部分限定第一安装端口，所述第一安装端口是从第一末端模块区段的近端可进入的。第一末端区段还可以包括在第一区段的远端处的止挡部分。
在一个实施方案中，相对的末端体部横截面可以互补于第一末端轨道部分的第一末端轨道横截面以用于沿第一末端轨道轴在第一末端模块区段和相对的末端模块区段之间的滑动接合。相对的末端模块区段的多个凹穴中的每个的位置和尺寸可以被调整为互补于第一末端模块区段的多个倒钩中的相应的一个。当处于植入构型时，第一末端轨道部分的完全相对的倒钩适用于在相对的末端模块区段的体部的多个凹穴内的捕获。第一末端模块区段和相对的末端模块区段可以适用于彼此互锁以限定这样的植入构型，所述植入构型呈现总体上对应于抽空的髓核空间的总体上连续的外周。
在另一个实施方案中，构成假体的多个模块区段包括中间的模块区段，所述中间的模块区段具有中间的体部和中间的轨道部分。中间的轨道部分延伸自中间的体部的侧翼面，中间的轨道部分限定中间的轨道轴，中间的轨道轴通过中间的模块区段的近端和远端。中间的轨道部分可以包括多个完全相对的倒钩，所述倒钩相对于中间的轨道轴在径向上向外地并且平行于中间的模块区段的上/下坐标延伸。中间的轨道部分限定正交于中间的轨道轴的中间的横截面。
中间的体部限定具有内表面的中间的细长槽，中间的细长槽通过中间的体部以限定中间的槽轴。中间的轨道轴和中间的槽轴可以基本上彼此平行并且位于中间的模块区段的横平面上，中间的体部限定垂直于中间的槽轴的中间的体部横截面。中间的模块区段的体部还可以限定多个凹穴，所述多个凹穴从中间的细长槽的内表面凹进并且相对于中间的槽轴在径向上向外地并且平行于中间的模块区段的上/下坐标延伸。在一个实施方案中，中间的体部包括上唇部分和下唇部分，其各自邻近中间的细长槽并且平行于中间的槽轴延伸并且各自向中间的模块区段的横平面突出。
在本发明的一个实施方案中，中间的体部横截面互补于第一末端轨道部分的第一末端轨道横截面以用于沿第一末端轨道轴在第一末端模块区段和中间的模块区段之间的滑动接合。中间的模块区段的多个凹穴中的每个的位置和尺寸可以被调整为互补于第一末端模块区段的多个完全相对的倒钩中的相应的一个。当处于植入构型时，第一末端轨道部分的完全相对的倒钩可以被配置成用于在中间的模块区段的多个凹穴内的捕获。在该实施方案中，相对的末端体部横截面互补于中间的轨道横截面以用于沿中间的轨道轴在相对的末端模块区段和中间的模块区段之间的滑动接合。相对的末端模块区段的多个凹穴中的每个的位置和尺寸可以被调整为互补于中间的模块区段的多个完全相对的倒钩中的相应的一个。当处于植入构型时，中间的轨道部分的完全相对的倒钩可以适用于在相对的末端模块区段的体部的多个凹穴内的捕获。第一末端模块区段可以适用于与中间的模块区段互锁，并且中间的模块区段适用于与相对的末端模块区段互锁以限定这样的植入构型，所述植入构型呈现总体上对应于抽空的髓核空间的总体上连续的外周。
在不同的实施方案中，各个模块区段是均质的材料的，所述均质的材料具有约2至约100MPa的压缩模量。
在不同的实施方案中，多个模块区段中的每个包括限定安装端口的结构，所述安装端口被布置在近端上并且从所述近端是可进入的，所述安装端口包括内表面和从所述内表面的第一侧伸出的多个制动装置，其中与第一侧相对的第二侧限定圆柱形的表面。
在本发明的另一个实施方案中，用于配置模块髓核假体的系统包括多个插入工具，所述多个插入工具与多个区段中的每个一一对应，并且所述各自包括尖端部分，所述尖端部分具有在其一侧上形成的多个凹槽，所述尖端部分沿旋转轴延伸并且其尺寸被调整为用于插入到模块区段的安装端口中，凹槽被配置成与安装端口内的制动装置配合。通过围绕中心轴旋转插入工具，尖端部分可以是从相应的一个安装端口可选择地释放的。
本发明的不同的实施方案适于从相对于上/下坐标的任何方向的植入(即，后侧接近、前侧或侧面入路，或其间的任何入路)。
附图简述
图1描绘本发明的实施方案中的髓核置换系统的不同的组件；
图2A至2D是本发明的不同的模块髓核假体实施方案的透视图；
图3A至3C是本发明的实施方案中的图2A至2D的假体的单独的模块区段的透视图；
图4是本发明的实施方案中的第一末端模块区段(“A-区段”)的截面图；
图5是本发明的实施方案中的中间的模块区段(“B-区段”)的截面图；
图6是本发明的实施方案中的图4和5的模块区段的细长槽部分的截面图；
图7是本发明的实施方案中的相对的末端模块区段(“C-区段”)的截面图；
图8是本发明的实施方案中的备选的轨道部分和体部构型的部分截面图；
图9是本发明的实施方案中的A-区段或B-区段的侧视图；
图10是本发明的实施方案中的横平面处的B-区段的截面图；
图11是本发明的实施方案中的A/B插入工具的分解图；
图11A是本发明的实施方案中的图11的A/B插入工具的尖端部分的放大的正视图；
图11B是本发明的实施方案中的图11的A/B插入工具的“D形的”轴杆部分的截面图；
图12是本发明的实施方案中的A-或B-区段/插入工具组合件的组装的透视图；
图12A是图12的组装的正视图；
图13A至13H描绘本发明的实施方案中的模块髓核假体的组装；
图14是本发明的实施方案中的拆除工具的侧视图；
图14A是图14的拆除工具的截面图；
图15A至15D描绘本发明的实施方案中的图14的拆除工具的操作；
图16是本发明的实施方案中的A-区段稳定器的透视图；
图16A是本发明的实施方案中的图16的A-区段稳定器的侧视图；
图17是本发明的实施方案中的B-区段稳定器的透视图；
图17A是本发明的实施方案中的图17的B-区段稳定器的截面图；
图17B是本发明的实施方案中的图17的B-区段稳定器的部分平面图；
图18A和18B是平面图，其描绘本发明的实施方案中的A-区段稳定器与A-区段/插入工具组合件的耦接；
图19是本发明的实施方案中的C-区段插入工具的透视图；
图19A是本发明的实施方案中的C-区段插入工具的端视图；
图19B是本发明的实施方案中的图19的C-区段插入工具的尖端部分的部分正视图；
图20是本发明的实施方案中的C-区段稳定器C-区段插入工具的透视图；
图20A是本发明的实施方案中的图20的C-区段稳定器C-区段插入工具的正视图；并且
图20b是本发明的实施方案中的图20的C-区段稳定器C-区段插入工具的端视图。
详述
参看图1，髓核置换系统30被描绘在本发明的实施方案中。髓核置换系统30包括用于模块髓核假体34a至34d(图2)(下文中“假体”)”的装配的模块区段32a、32b和32c，用于安装假体的模块区段32的插入工具36a和36c，和促进假体安装的多种工具，包括装载平台42，拆除工具44，A-区段稳定器46，B-区段稳定器48和C-区段稳定器52。
贯穿本文，注意到某些组件具有由数字以及之后的字母后缀组成的数字参考(例如，以上的模块区段32a、32b和32c和插入工具36a和36c)。当使用此编号规定时，数字一般地或整体地指物品，而字母具体地指物品。根据此规定，当仅涉及数字时，对物品的参考是一般的或整体的(例如，模块区段32或插入杆36)。
参看图2A至2D(总的被称为图2)和图3A至3C(总的被称为图3)，多种假体和构建其的模块区段被描绘在本发明的实施方案中。各个假体32a至32d包括彼此互锁的多个模块区段32(即，至少两个区段)。各个模块区段32包括上方侧62，下方侧64，近端66，和与近端66相对的远端68。各个模块区段32的上方侧和下方侧62和64被布置在各自的模块区段32的横平面72a、72b和72c的相对的面上，当处于植入构型时，横平面72a、72b和72c正交于各自的模块区段32a、32b和32c的上/下坐标74a、74b和74c。近/远坐标76a、76b和76c也被限定为正交于上下坐标74a、74b和74c并且在从近端66到远端68的方向上延伸。当处于植入构型时，多个模块区段32中的每个适合于以相对于各个横平面72的并排的布置方式与多个模块区段中邻近的一个互锁。
上方和下方侧62和64被如此命名以符合其沿各自的上/下坐标74或上/下方向的方位(当假体34以植入构型被安装在人体内时)。在一个实施方案中，假体34的模块区段32可以相对于横平面72对称；即，对于该实施方案，各个模块区段32的上方侧62是下方侧64相对于横平面72的镜像，因此确定横平面72为中心横平面78。
图2中描绘的假体包括图3中描绘的多达三种模块区段类型：第一末端模块区段32a，其在本文中被备选地称为“A”区段(图3A)；中间的模块区段32b，其在本文中被备选地称为“B”区段(图3B)；和相对的末端模块区段32c，其在本文中被备选地称为“C”区段(图3C)。在本发明的不同的实施方案中，假体34可以包括一个或多个B-区段32b，或可以不具有B-区段32b(即，A-区段32a直接连接至C-区段32c，如图2A中所示)。虽然单独的B-区段32b的长度、宽度和厚度尺寸可以变化，但是一般特性与以下所述相同。在采用多个B-区段32b的一些实施方案中，B-区段32b是相同的。
参看图4并再次参看图3A，第一末端模块区段32a(A-区段)被描绘在本发明的实施方案中。第一末端模块区段32a包括体部84a和轨道部分82a，轨道部分82a延伸自体部84a的侧翼面86a。在一个实施方案中，轨道部分82a包括网状物88a和轨头92a，侧翼面86a和轨头92a被网状物88a隔开。轨头92a可以限定轨道轴94a，轨道轴94a通过模块区段32a的近端和远端66a和68a。轨道部分82a也可以包括多个完全相对的倒钩部分96a，倒钩部分96a相对于轨道轴94a在径向上向外地并且平行于第一末端模块区段32a的上/下坐标74a延伸。在一个实施方案中，第一末端模块区段32a包括位于远端68a的止挡部分98a。第一末端模块区段32a的轨道部分82a和体部84a的横截面102a和104a分别描绘于图4，横截面102a、104a垂直于轨道轴94a。
本文中，第一末端模块区段32a的轨道部分82a，轨道轴94a，轨道部分横截面102a，体部82a和体部横截面104a备选地被分别称为第一末端轨道部分82a，第一末端轨道轴94a，第一末端轨道横截面102a，第一末端体部82a，和第一末端体部横截面104a，以表明与第一末端模块区段32a的关联。
参看图5和6并且再次参看图3B，中间的模块区段32b(B-区段)被描绘在本发明的实施方案中。中间的模块区段32b包括体部82b和轨道部分82b，轨道部分82b自体部82b的侧翼面86b伸出。在一个实施方案中，轨道部分82b包括网状物88b和轨头92b，侧翼面86b和轨头92b被网状物88b隔开。轨头92b可以限定轨道轴94b，轨道轴94b通过模块区段32b的近端和远端66b和68b。轨道部分82b也可以包括多个完全相对的倒钩部分96b，倒钩部分96b相对于轨道轴94b在径向上向外地并且平行于中间的模块区段32b的上/下坐标74b伸出。在一个实施方案中，中间的模块区段32b包括位于其远端的止挡部分98b。中间的模块区段32b的轨道部分82b和体部84b的横截面102b和104b分别被描绘在图5处，横截面102b、104b垂直于轨道轴94b。
中间的模块区段32b的体部84b限定细长槽112b，细长槽112b通过体部84b并且包括内表面114b。细长槽112b还限定槽轴116b，槽轴116b基本上平行于中间的模块区段32b的中间的轨道轴94b。在一个实施方案中，轨道轴94b和槽轴116b位于中间的模块区段32b的横平面72b上。在图示的实施方案中，横平面72b对应于中央横平面78b。体部84b也可以包括多个凹穴118b，所述多个凹穴118b平行于上/下坐标74b在相对于槽轴116b的上下两个方向上延伸(图6)。
本文中，中间的模块区段32b的轨道部分82b、轨道轴94b、轨道部分横截面102b、体部84b、细长槽112b、槽轴116b和体部横截面104b备选地被称为中间的轨道部分82b、中间的轨道轴94b、中间的轨道部分横截面102b、中间的体部84b、中间的细长槽112b、中间的槽轴116b和中间的体部横截面104b，以表明与中间的模块区段32b的关联。
中间的体部84b也可以被表征为具有上唇部分122b和下唇部分124b，其各自因其沿相对于横平面72b的上/下坐标74b的位置而被命名。唇部分122b、124b邻近并且部分地限定中间的细长槽112b，并且向彼此突出。间隙126b被限定在上唇部分122b和下唇部分124b之间，限定细长槽112b的开放侧128b。在图示的实施方案中，各个唇部分122b、124b向中央横平面78b突出。唇部分122b和124b也可以限定相对的侧翼面130b，侧翼面130b面向与中间的体部84b的侧翼面86b相反的方向。
参看图7并再次参看图6，相对的末端模块区段32c(C-区段)被描绘在本发明的实施方案中。(注意到图6中描绘的横截面适用于图5和7两者)。相对的末端模块区段32c包括限定细长槽112c的体部84c，细长槽¨2c还限定位于横平面72c上的槽轴116c。细长槽112c包括内表面114c并且通过相对的末端模块区段32c的体部84c。体部84c包括垂直于槽轴116c的体部横截面104c。相对的末端模块区段32c的体部84c也可以包括与中间的模块区段32b的上唇部分和下唇部分122b和124b具有相同特性的上唇部分122c和下唇部分124c。相对的末端模块区段32c的体部84c还可以限定多个凹穴118c，凹穴118c自体部84c的细长槽112c的内表面114c凹进。凹穴118c可以相对于槽轴116c在径向上向外并且平行于相对的末端模块区段32c的上/下坐标74c伸出。
本文中，相对的末端模块区段32c的体部84c、细长槽112c、槽轴116c和体部横截面104c备选地被称为相对的末端体部84c、相对的末端细长槽112c、相对的末端槽轴116c和相对的末端体部横截面104c，以表明与相对的末端模块区段32c的关联。
轨头92可以各自包括面132，面132是基本上平坦的并且基本上平行于各个上/下坐标74，面132由此相对于各个网状物部分88成直角。邻近的、配合模块区段32的、互补于轨道部分82的体部84可以包括上唇部分和下唇部分122和124，上唇部分和下唇部分122和124也包括内面134，内面134是基本上平坦的并且基本上平行于上/下坐标74(例如，图5和7)。
参看图8，备选的轨道横截面102d和配合体部横截面104d呈现在本发明的实施方案中。对于这些实施方案，唇部分122d、124d也包括面132d，面132d各自是基本上平坦的，但是各自相对于上/下坐标74d是倾斜的从而限定“燕尾”轮廓。即，邻近轨道部分82d的网状物88d的轨头92d的平坦平面132d以锐角θ与网状物88d交叉。邻近的、配合区段的、互补的体部84d还限定相对网状物部分88d的锐角θ。
在功能上，面132和网状物部分88之间的直角或锐角构型增强邻近区段之间在垂直于上/下坐标74和轨道轴94两者的方向上的机械耦接。这些构型主要依赖于接合的区段之间的压缩接触并且较少地依赖于区段之间的摩擦，由此在其间提供正性机械耦接。当区段包含具有相对低的硬度的软的或顺应的材料时，增强的耦接尤其有利。软的或顺应的材料的非限制性实例是聚合物如生物相容性聚氨酯。软的或顺应的材料的硬度的非限制性实例是具有约Shore 18A至约Shore 55D的硬度计硬度的材料。软的或顺应的材料的另外的和非限制性的实例是具有约2至约100MPa的压缩模量的材料。在优选的实施方案中，压缩模量为约6至约20MPa。
不同轨道部分82和不同体部84的横截面102和104可以被配置成互补于自身和其他模块区段32。即，不同的轨道部分横截面102的形状和尺寸可以被调整为配合不同的体部横截面104。同样地，不同的凹穴118的位置和尺寸可以被调整为接纳(即，互补于)模块区段32的不同的轨道部分82上的倒钩部分96。
以此方式，特定的A-区段32a可以耦接至特定的B-区段32b或特定的C-区段32c，特定的C-区段32c可以耦接特定的A-区段32a或特定的B-区段32b，而特定的B-区段32b可以耦接另一个B-区段32b。系统的模块性使得能够通过以并排的方式将不同的区段互锁在一起构建多种假体尺寸，A、B和C-区段32a、32b和32c构成模块系统的构件块。
在某些实施方案中，不同的区段的侧翼面86相对于轨道轴94是倾斜的(即，不平行于轨道轴94)。代替地，从近端66到远端68，侧翼面86以角度α稍向轨道轴94倾斜，如最佳见于图18A的。即，侧翼面86在近端66处比在远端68处更远离轨道轴94。因此，对于包括该特征的实施方案，特定的模块区段32的轨道轴94将在远离模块区段32的点处与各个侧翼面86的平面交叉。
为了适应倾斜的侧翼面构型，模块区段32b和32c的唇部分122、124从各个体部84b、84c的近端66到远端68可以具有变化的厚度。虽然特定的唇部分122、124的内面134平行于各个槽轴116，但是唇部分122、124的厚度(即，垂直于槽轴116的尺寸)可以自近端66到远端68减小，以致唇部分122、124自身与邻近的模块区段32a或32b的倾斜的侧翼面86形成互补的倾斜的界面。
参看图9，模块区段32a或32b的侧视图呈现在本发明的实施方案中。倒钩部分96可以各自限定倾斜的轮廓142。倾斜的轮廓142与轨道部分82的外表面相交于在倒钩部分96的近端上的交点144。从交点144，倒钩部分的尺寸向倒钩部分96的远端146增加。在图示的实施方案中，倒钩部分96的远端146平行于各个模块区段32的上/下坐标74。因此，在该实施方案中，倒钩部分96各自在平行于特定的区段32a、32b的上/下坐标74和轨道轴94两者的平面中限定直角三角形的轮廓。
在一个实施方案中，邻近的模块区段32b或32c的体部84的相应的凹穴118可以限定相似的、三角形，所述三角形互补于倒钩部分96的三角形(图6)。在其他实施方案中，凹穴118可以是，例如，矩形的，只要凹穴118的远端边界148互补于倒钩部分96的远端146即可。
为了装配例如图2b的植入物，B-区段32b被置于邻近A-区段32a的近端，以使得B-区段32b的体部84b的槽轴116b基本上与A-区段32a的轨道部分82a的轨道轴94a同心。然后B-区段32b的体部84b在沿轨道轴94a的远端方向上在A-区段32a的轨道部分82a上滑动直至轨道部分82a的倒钩部分96a被捕获在B-区段32b的体部84b的凹穴118b内。当A-区段32a的倒钩部分96a被固定在B-区段32b的凹穴118b内时，B-区段32b的体部84b的远端68b可以基本上与A-区段32a的止挡部分98a对整齐。
当B-区段32b的体部84b在A-区段32a的轨道部分82a上滑动时，B-区段32b的细长槽112b的内表面114b压制A-区段32a的突出的倒钩部分96a。此相互作用导致A-区段32a的倒钩部分96a被压缩并且B-区段32b的体部的壁向上偏转。然而，在倒钩部分96a在各个凹穴118b内对整齐后，基本上没有组件的变形。
在B-区段32b被固定到A-区段32a后，C-区段32c被置于邻近B-区段32b的近端，以使得C-区段32c的体部的槽轴116c基本上与B-区段32b的轨道轴94b同心。然后C-区段32c的体部82c在沿轨道轴94b的远端方向上在B-区段32b的轨道部分82b上滑动直至轨道部分82b的倒钩部分96b被捕获在C-区段32c的体部84c的凹穴118c内。当B-区段32b的倒钩部分96b被固定在C-区段32c的凹穴118b内时，C-区段32c的体部84c的远端68c可以基本上与B-区段32b的止挡部分98b对整齐。
对于2-区段植入物(图2A)，C-区段32c以类似方式与A-区段32b直接互锁。同样地，对于具有四个以上区段的植入物，以类似方式互锁另外的中间的B-区段。作为非限制性实例，实施方案可以具有多至8个模块区段(一个A-区段32a，一个C-区段32c，和六个B-区段32b)。
在功能上，模块区段32的轨道和槽部分82、112的不同的结构特征防止在所有方向上的模块区段32之间的相对移动(即使是在相对软的或顺应的材料被用于模块区段32时)。特定的轨道部分82与邻近的体部84的接合防止沿上/下坐标74的接合的区段之间的相对移动。当与邻近的区段32接合时，特定的模块区段32的倒钩部分96和止挡部分98之间的接合防止沿近/远坐标76的接合的区段32之间的相对移动。唇部分122和124与倒钩部分96两者提供对平行于横平面72的移动的剪切阻力。特定的模块区段32的上唇和下唇部分122和124以及邻近的、接合的模块区段32的倒钩部分96防止模块区段32分开。
倒钩部分96的倾斜的轮廓142使得当邻近的区段32在相对于特定的区段32的远端方向上移动时，邻近的区段32的体部84能够更容易地在倒钩部分96上滑动。然而，在倒钩部分96在其相应的凹穴118内对整齐后，倒钩部分96的远端146与凹穴118的远端边界148相互作用以防止邻近的区段沿近/远坐标76移动。
对于利用倾斜的侧翼面86的实施方案，在侧翼面86和邻近的区段的上唇和下唇部分122和124之间几乎没有或没有滑动干扰直至邻近的区段处于或接近植入的位置。这有助于限制装配期间的摩擦负荷。
参看图10，呈现的是通过横平面72b切割的B-区段32b的横截面，其描绘本发明的实施方案中的安装端口152b。模块区段32可以各自包括这样的安装端口152以用于安装各个模块区段32到插入工具。虽然以下讨论针对安装端口152b，一般特征适用于所有安装端口152。
在一个实施方案中，安装端口152b限定基本上圆柱形的腔体154b，圆柱形的腔体154b关于模块区段32b的轨道轴94b是同心的并且是从模块区段32b的近端66b可进入的。安装端口152b还可以包括从安装端口152b的内壁158b的一侧伸出的内部制动装置156。在一个实施方案中，制动装置156可以各自限定三角形的或直角三角形的轮廓162，其中各个制动装置156的近侧面164相对于轨道轴94b是倾斜的并且制动装置156的远侧面166正交于轨道轴94b或相对于轨道轴94b仅稍微呈锐角。
参看图11、11A和11B，用于增加A-和B-模块区段32a和32b两者的插入的A/B插入工具36a被描绘在本发明的实施方案中。A/B插入工具36a包括轴杆部分172a，轴杆部分172a具有从近端176a伸出的旗形物174a和从远端182a伸出的尖端部分178a。尖端部分178a限定旋转轴184a并且还限定在一侧形成的凹槽186，凹槽186的形状和位置被调整为互补于安装端口152的制动装置156。在某些实施方案中，轴杆部分172a包括与模块区段32的轨头92具有相同轮廓的横截面188a。因此，当处于关于旋转轴184a的合适的旋转定向时，轴杆部分172a有效地提供轨头92的近侧延伸。在图示的实施方案中，A/B插入工具36a的轴杆部分172a限定具有弓形部分192a和平坦面部分194a的“D形的”轮廓190a。A/B插入工具36a的旗形物174a可以是如图11中所示的“L形的”，其中旗形物174a的短腿196a从D形的轴杆部分172a的平坦面部分194a伸出。
参看图12和12A，A/B插入工具36a与A-和B-区段32a和32b中的一个的组装被描绘在本发明的实施方案中。在一个实施方案中，组装可以通过区段装载平台200扩充。在一个实施方案中，区段装载平台200包括区段湾202，区段湾202与“U形的”通道204对齐，通道204具有关于装载轴208同心的弓形部分206。区段湾202被配置成具有底部212，底部212被配置成接收模块区段32a或32b的轨道部分并与其对整齐。U形的通道204的尺寸被调整为用于与轴杆部分172a的D形的轮廓190a滑动接合。
A-或B-区段32a或32b中的一个被置于区段湾202中以使得区段32的轨道部分82在区段湾的底部内适当地对整齐。A/B插入工具36a的轴杆部分172a被置于区段装载平台200的U形的通道204内以使得D形的轮廓190a的弓形部分192a与U形的通道204的弓形部分206对整齐。模块区段32a或32b和A/B插入工具36a的轴杆部分172a的对整齐(registration)使尖端部分178a的旋转轴184a和相应的模块区段32a或32b的轨道轴94a(并且因此安装端口152a或152b)对齐。所述对整齐还旋转地定向A/B插入工具36a的尖端部分178a和模块区段32a或32b的安装端口152a或152b以使得尖端部分178a的凹槽与安装端口152a或152b的制动装置156a或156b对齐。尖端部分178a滑动到安装端口152a或152b中直至安装端口152a或152b的多个制动装置156a或156b中的每个占据尖端部分178a上的相应的一个凹槽186a。
注意到C-区段32c不包括安装轨道，并且因此不可以包括与轨道部分同心的安装端口。因此，C-区段包括形成在体部84c中的安装端口152c，安装端口152c限定平行于与槽轴116c相同的横平面72c并在其上的轴214并且具有与A-和B-区段32a和32b的安装端口152a和152b相同的特征。
参看图13A至13H，描绘的是图2B的三区段假体34b的组装顺序。包括A-区段32a和A/B插入工具36a的A-区段/插入工具组合件220a被首先置于抽空的髓核空间中(图13A；抽空的髓核空间未示)。包括B-区段32b和另一个A/B插入工具36b的B-区段/插入工具组合件220b然后在A-区段/插入工具组合件220a的近端222a上滑动并且沿A-区段/插入工具组合件220a的A/B插入工具36a的轴杆172a平移(图13B)。在该步期间，B-区段32b的细长槽112b的开放侧128b被调整为在A-区段/插入工具组合件220a的A-区段插入工具36a的L形的旗形物174a的短腿196a上经过，这也将B-区段32b的细长槽112b置于正确的定向以用于沿B-区段/插入工具组合件220b的A/B插入工具36b的D形的轴杆172a的平移。
B-区段32b然后在A-区段32a的轨道部分82a上滑动直至B-区段32b与A-区段32a的止挡部分98a对整齐(图13C)。细长槽112b的开放侧128b在轨道部分82b的网状物88b上滑动，当在L形的旗形物174a的短腿196a上滑动时，开放侧128b已经被适当地调整。使用者可以确定，当A-和B-区段插入工具组合件220a和220b的A/B插入工具36a和36b的旗形物174a和174b对齐时，B-区段32b在应有的位置上。在B-区段32b与A-区段32a的止挡部分98a对整齐后，A-区段32a的轨道部分82a上的倒钩部分96a应当在B-区段32b的凹穴118b内对整齐。然而，使用者可以在相对于A-区段/插入工具组合件220a的近端方向上拖动B-区段/插入工具组合件220b以保证倒钩部分96a被安置在凹穴118b内。
然后移除A-区段/插入工具组合件220a的A/B插入工具36a。移除通过围绕旋转轴184a将A-区段/插入工具组合件220a的A/B插入工具36a旋转180°实现(图13D)。该动作导致A-区段/插入工具组合件220a的A/B插入工具36a的尖端部分178a的凹槽186a远离A-区段32a的安装端口中的制动装置156a旋转，因此在减少来自制动装置156a的干扰的情况下使得A-区段/插入工具组合件220a的A/B插入工具36a能够从安装端口156a中移除。然后将A-区段/插入工具组合件220a的A/B插入工具36a从安装端口152a移除，仅留下与B-区段/捅入工具组合件220b耦接的A-和B-区段32a和32b(图13E)。
然后布置包括C-区段32c和C插入工具36c的C-区段/插入工具组合件220c以使得C-区段32c的槽部分112c在B-区段/插入工具组合件220b的近端222b上滑动，并且C-区段/插入工具组合件220b沿B-区段/插入工具组合件220b的插入工具36b的轴杆172b平移(图13F)。以下在关于图19的讨论中更详细地描述C插入工具36c。然后C-区段32c在B-区段32b的轨道部分82b上滑动直至C-区段32c与B-区段32b的止挡部分98b对整齐(图13G)。然后将B-区段/插入工具组合件220b的插入工具36b移除(图13H)。以与在图13B至13E处所描绘的步骤相同的方式进行在图13F至13H处描绘的步骤。
通过将插入工具36c旋转180°(图13H)并且将其从安装端口152c移除来将C-区段/插入工具36c的插入工具移除，由此留下在应有的位置完全装配好的假体(图2B)。
在某些实施方案中，可以包括辅助工具并且可以将其用于模块区段的增强操作。当操纵均质的、顺从材料的模块区段时，辅助工具尤其有用。辅助工具可以包括拆除工具44，A-区段稳定器46，B-区段稳定器48和C-区段稳定器52(图1)。
参看图14和14A，拆除工具44被描绘在本发明的实施方案中。拆除工具44包括手柄部分232和轴杆部分234。轴杆部分234限定孔236，孔236具有关于中心轴242同心的内径238。孔236的内径238的尺寸被调整为足够大以在A-和B-区段插入工具36a或36b的D形的轮廓190a或190b以及C-区段插入工具36c的圆形轮廓上滑动。拆除工具44包括在其一侧上的槽244，槽244在拆除工具的一侧上延伸并且从邻近拆除工具44的近端248的位置246延伸到拆除工具44的远端252。
参看图15A至15D，拆除工具44的操作被描绘在本发明的实施方案中。典型地，在插入工具已被旋转180°以脱离制动装置156和凹槽186后(图15A和15B)，拆除工具44的中心轴242与插入工具36的旋转轴184对齐并且在插入工具36的近端176上滑动，槽244被布置成在L形的旗形物174的短腿196上经过。拆除工具44的轴杆部分234在插入工具36的轴杆部分172上滑动直至拆除工具44的远端252与模块区段32接触(图15C)。然后通过在插入工具36的旗形物部分174和拆除工具44的手柄部分232之间施加夹紧力F将插入工具44从安装端口152拉出(图15D)。操作员典型地通过在手的食指和拇指或手掌之间挤压旗形物部分174和手柄部分232来施加夹紧力F。
在功能上，虽然将特定的插入工具36旋转180°的动作使得从安装端口152移除插入工具36更容易，但是插入工具36的尖端部分178和模块区段32之间的摩擦仍然可能相当大，部分是因为在180°旋转后制动装置156被压向尖端部分178的圆柱形的表面。拆除工具44提供控制的、机械杠杆的方式以原位移除插入工具36同时保持低轮廓。
参看图16、16A、17、17A和17B，A-和B-区段稳定器46和48被描绘在本发明的实施方案中。A-和B-区段稳定器46和48包括很多共同的特征，所述特征被指示在具有同样编号的数字参考的图中。A-稳定器46包括轴杆部分262，轴杆部分262具有附在近端266处的手柄264。轴杆部分262包括有效地是通道结构268的结构，通道结构268限定在其一侧上的通道272，通道结构268包括相对的边缘274和276，边缘274和276由平坦部分278分开。因此限定的通道272的尺寸被调整为使得插入工具36能够可滑动地在其中平移，其中D形的轴杆172的平坦部分278与A-区段稳定器46的平坦部分278接合。在远端282，平坦部分278包括扩展部分284，扩展部分284延伸超过相对的边缘274、276，扩展部分284包括在其上形成的槽286。槽286沿伸长的轴292形成并且是从远端282可进入的。
B-区段稳定器48还包括通道结构268，通道结构268从近端266延伸到远端282附近。在近端266，B-区段稳定器包括在通道272内形成的斜坡部分294。在没有手柄的情况下，B-区段稳定器包括在近端266上形成的夹持部分296。在远端282附近，B-区段稳定器48包括额外的导引结构302，导引结构302有效地限定不对称的工字梁轮廓304。通道结构272和导引302结构沿B-区段稳定器48的长度连续地限定通道272。导引结构302包括相对的边缘274和276，边缘274和276在两个方向上垂直于平坦部分278延伸。导引结构302还包括相对的唇部分306，所述相对的唇部分306朝向彼此延伸以在其间限定间隙308。
参看图18A和18B，A-区段稳定器46的操作被描绘在本发明的实施方案中。在将A-区段32a插入到抽空的髓核空间中之前，A-区段/插入工具组合件220a被装载到A-区段稳定器46的通道272中(图18A)。在装载之后或同时，A-区段稳定器46向A-区段32a平移直至轨道部分82a的网状物88a在槽286内对整齐(图18B)。
对于B-区段稳定器48，导引结构302在A插入工具36a的远端176a上滑动以在边缘部分274，276和B-区段稳定器48的导引结构302的唇部分306之间捕获A插入工具36a的D形的轴杆部分172a(显示在图17A中的虚影中)。B-区段稳定器48的通道272在B-区段/插入工具组合件220b上平移直至轨道部分82b的网状物88b在槽286对整齐。在图示的实施方案中，B-区段稳定器48不包括类似于A-区段稳定器46的手柄，因为这样的手柄将在A-和B-插入工具36a和36b的旗形物178a和178b之间产生混乱和干扰。以此方式，原位提供用于将B-区段32b耦接至A-区段32a的额外的导引和控制。
在假体34的组装期间，斜坡部分294导引在插入工具36a和36b的近端处的旗形物174a和174b彼此远离。这防止A/B插入工具36B的旗形物174b碰到邻近的A/B插入工具36a的旗形物174a。
A-和B-区段稳定器46和48的移除通过在近端方向上使其与各个轨道部分82a、82b的网状物88a、88b脱离来实现。
参看图19、19A和19B(总的被称为图19)，C插入工具36c被描绘在本发明的实施方案中。C插入工具36c包括轴杆部分172c，轴杆部分172c具有在远端182c的尖端部分178c和在近端176c的旗形物部分174c。在一个实施方案中，旗形物部分174c在与A/B插入工具36a、36b的旗形物部分174a、174b相反的方向上延伸。尖端部分178c限定尖端部分轴310。C插入工具36c的尖端部分178c的凹槽特征186c可以与A/B插入工具36a的相同。C插入工具36c的轴杆部分172c围绕圆柱形轴312基本是圆柱形的。在图示的实施方案中，轴杆部分172c的圆柱形轴312和尖端部分178c的尖端部分轴310不是同心的(图19A和19B)。
参看图20、20A和20B，C-区段稳定器52被描绘在本发明的实施方案中。C-区段稳定器52包括空心的轴杆部分322，空心的轴杆部分322具有在近端326上的手柄324和远端332附近的导引结构328。空心的轴杆部分322包括限定槽334的结构，槽334在其第一侧336上延伸并且从邻近近端326的位置338延伸到C-区段稳定器52的远端332。导引结构328包括从空心的轴杆部分322的第二侧346伸出的两个相对的边缘342和344，第二侧346与第一侧336相对。相对的边缘342、344各自包括唇部分352，唇部分352向彼此延伸以在其间限定间隙356。A/B插入工具36b和C插入工具36c被描绘在图20B中的虚影中。
在操作中，C-区段稳定器52的空心的轴杆部分322与C插入工具36c的圆柱形轴312对齐并且与槽334对齐从而在旗形物部分174c上经过。然后C-区段稳定器52在C插入工具36c上平移直至远端332接合C-区段32c。
在功能上，导引结构328在导引结构328的边缘324和344之间捕获邻近的A/B插入工具36b的D形的轴杆172c，从而进一步帮助使用者将B-区段32b导引到抽空的髓核空间中。C-区段稳定器的槽334使得空心的轴杆部分322能够在C插入工具36c的轴杆旗形物部分174c上经过。同样地，间隙356使得导引结构328能够在A/B插入工具36b的旗形物部分174b上经过。空心的轴杆322的内径的尺寸被调整为这样以致A/B插入工具36b不能被插入到C-区段稳定器中。因此，C-区段稳定器52的圆形的空心的轴杆322充当防止A/B插入工具36a插入其中的关键。尖端部分178c相对于轴杆部分172c的偏心为插入工具36b和36c之间的空心的轴杆部分322的结构提供空间。C-区段稳定器52的远端332提供承压表面，其将插入操作的力分布在更大的区域上，因此在C-区段32c的插入期间防止C-区段32c变形。
A-、B-和C-区段稳定器46、48和52的目的总体在于使得能够在植入期间操纵各个A-，B-和C-区段32a、32b和32c，以及在假体34处于组装的不同阶段时在抽空的髓核空间内操纵假体34。在部分或完全装配的假体34的放置期间，稳定器46、48、52降低不同的插入工具36的尖端部分178与各个安装端口152脱离的风险。
在某些实施方案中，以上讨论的不同的组件被包括成用具包。所述用具包可以包括图1中呈现的组件中的一些或全部。所述用具包也可以包括在有形介质(如纸质文档、光盘(CD)、数字视频盘(DVD)或例如通过因特网访问的中央计算机)上的操作指令。操作指令可以包括以上描述的多种指令和顺序。

Claims (10)

1.适用于在抽空的髓核空间中植入的模块髓核假体，所述假体包括：
多个模块区段，其中各模块区段由单一的软的顺应材料形成，所述单一的软的顺应材料具有在整个所述多个模块区段上均匀的压缩模量和shore硬度，所述多个模块区段各自包括上方侧、下方侧、近端和与所述近端相对的远端，所述上方侧和下方侧被布置在各个模块区段的横平面的相对面上，当处于植入构型时，所述横平面正交于各个模块区段的上/下坐标，当处于所述植入构型时，所述多个模块区段中的每个适合于以并排的布置方式在所述横平面上与所述多个模块区段中邻近的一个互锁，
所述多个模块区段包括：
第一末端模块区段，所述第一末端模块区段包括第一末端体部和第一末端轨道部分，所述第一末端体部被配置成以所述单一的软的顺应材料接触抽空的髓核空间的外周，所述第一末端轨道部分从所述第一末端体部的侧翼面伸出，所述第一末端轨道部分限定第一末端轨道轴，所述第一末端轨道轴通过所述第一末端模块区段的近端和远端，所述第一末端轨道轴位于所述第一末端模块区段的所述横平面上，所述第一末端轨道部分包括多个完全相对的倒钩，所述多个完全相对的倒钩相对于所述第一末端轨道轴在径向上向外地并且平行于所述第一末端模块区段的上/下坐标地延伸，所述第一末端轨道部分具有垂直于所述第一末端轨道轴的第一末端轨道横截面，
其中所述第一末端轨道部分包括网状物和轨头，所述网状物被布置在所述轨头和所述侧翼面之间并且沿所述横平面延伸，其中所述轨头包括平坦平面，所述平坦平面以直角和锐角中的一个与所述网状物相交；
相对的末端模块区段，所述相对的末端模块区段包括相对的末端体部，所述相对的末端体部限定具有内表面的相对的末端细长槽，所述相对的末端体部被配置成以所述单一的软的顺应材料接触抽空的髓核空间，所述相对的末端细长槽通过所述相对的末端模块区段的所述相对的末端体部以限定相对的末端槽轴，所述相对的末端槽轴位于垂直于所述相对的末端模块区段的上/下坐标的横平面上，所述相对的末端模块区段的所述相对的末端体部限定垂直于所述相对的末端槽轴的相对的末端体部横截面，所述相对的末端模块区段的所述相对的末端体部还限定从所述相对的末端细长槽的所述内表面凹进的多个凹穴，所述多个凹穴中的每个相对于所述相对的末端槽轴在径向上向外地并且平行于所述相对的末端模块区段的上/下坐标地延伸，
其中所述相对的末端模块区段的所述相对的末端体部包括上唇部分和下唇部分，所述唇部分中的每个邻近所述相对的末端细长槽并且平行于所述侧翼面延伸并且各自向所述相对的末端模块区段的所述横平面突出，所述相对的末端模块区段的所述上唇部分和所述下唇部分中的每个限定与所述轨头的所述平坦平面互补的内面，
其中所述完全相对的倒钩和所述多个凹穴由所述单一的软的顺应材料限定以致所述完全相对的倒钩适于被捕获和保持在所述多个凹穴内，当处于植入构型时，所述单一的软的顺应材料促进肯定的互锁。
2.权利要求1所述的假体，其中：
所述相对的末端体部横截面互补于所述第一末端轨道部分的所述第一末端轨道横截面以用于沿所述第一末端轨道轴在所述第一末端模块区段和所述相对的末端模块区段之间的滑动接合；
所述相对的末端模块区段的所述多个凹穴中的每个的位置和尺寸被调整为互补于所述第一末端模块区段的所述多个完全相对的倒钩中的相应的一个；
当处于所述植入构型时，所述第一末端轨道部分的所述完全相对的倒钩适用于在所述相对的末端模块区段的所述相对的末端体部的所述多个凹穴内捕获；并且
所述第一末端模块区段和所述相对的末端模块区段适合于彼此互锁以限定植入构型，所述植入构型呈现总体上对应于所述抽空的髓核空间的基本上连续的外周。
3.权利要求1所述的假体，所述多个模块区段包括：
由所述单一的软的顺应材料形成的中间的模块区段，所述中间的模块区段包括中间的体部和中间的轨道部分，所述中间的体部限定中间的上方侧和中间的下方侧，其被配置成以所述单一的软的顺应材料接触抽空的髓核空间的外周，所述中间的轨道部分从所述中间的体部的侧翼面伸出，所述中间的轨道部分限定中间的轨道轴，所述中间的轨道轴通过所述中间的模块区段的近端和远端，所述中间的轨道部分包括多个完全相对的倒钩，所述多个完全相对的倒钩相对于所述中间的轨道轴在径向上向外地并且平行于所述中间的模块区段的上/下坐标延伸，所述中间的轨道部分具有垂直于所述中间的轨道轴的中间的横截面，
其中所述中间的体部限定具有内表面的中间的细长槽，所述中间的细长槽通过所述中间的体部以限定中间的槽轴，所述中间的轨道轴和所述中间的槽轴基本上彼此平行并且位于所述中间的模块区段的横平面上，所述中间的体部限定垂直于所述中间的槽轴的中间的体部横截面，所述中间的模块区段的所述中间的体部还限定多个凹穴，所述多个凹穴从所述中间的细长槽的所述内表面凹进并且相对于所述中间的槽轴在径向上向外地并且平行于所述中间的模块区段的上/下坐标延伸，
所述中间的体部包括上唇部分和下唇部分，所述上唇部分和下唇部分各自邻近所述中间的细长槽并且平行于所述侧翼面延伸并且各自向所述中间的模块区段的所述横平面突出。
4.权利要求3所述的假体，其中：
所述中间的体部横截面互补于所述第一末端轨道部分的所述第一末端轨道横截面以用于沿所述第一末端轨道轴在所述第一末端模块区段和所述中间的模块区段之间的滑动接合，所述中间的模块区段的所述多个凹穴中的每个的位置和尺寸被调整为互补于所述第一末端模块区段的所述多个完全相对的倒钩中的相应的一个，当处于所述植入构型时，所述第一末端轨道部分的所述完全相对的倒钩被配置成用于在所述中间的模块区段的所述多个凹穴内的捕获；并且
所述相对的末端体部横截面互补于所述中间的轨道横截面以用于沿所述中间的轨道轴在所述相对的末端模块区段和所述中间的模块区段之间的滑动接合，所述相对的末端模块区段的所述多个凹穴中的每个的位置和尺寸被调整为互补于所述中间的模块区段的所述多个完全相对的倒钩中的相应的一个，当处于所述植入构型时，所述中间的轨道部分的所述完全相对的倒钩适用于在所述相对的末端模块区段的所述相对的末端体部的所述多个凹穴内的捕获；并且
所述第一末端模块区段适用于与所述中间的模块区段互锁，并且所述中间的模块区段适用于与所述相对的末端模块区段互锁以限定植入构型，所述植入构型呈现总体上对应于所述抽空的髓核空间的总体上连续的外周。
5.权利要求1所述的假体，其中所述单一的软的顺应材料具有2至100MPa的压缩模量。
6.权利要求1所述的假体，其中所述第一末端模块区段还包括在所述第一末端模块区段的远端处的止挡部分。
7.权利要求1所述的假体，其中所述第一末端轨道部分限定第一安装端口，所述第一安装端口是从所述第一末端模块区段的近端可进入的。
8.权利要求1所述的假体，其中所述横平面对应于中心横平面。
9.权利要求3所述的假体，其中所述多个模块区段中的每个包括限定安装端口的结构，所述安装端口被布置在所述近端上并且从所述近端是可进入的，所述安装端口包括内表面和从所述内表面的第一侧伸出的多个制动装置，其中与所述第一侧相对的第二侧限定圆柱形的表面。
10.用于配置权利要求9所述的模块髓核假体的系统，所述系统包括：
多个插入工具，所述多个插入工具与所述多个模块区段中的每个一一对应，并且所述多个插入工具各自包括尖端部分，所述尖端部分具有在其一侧上形成的多个凹槽，所述尖端部分沿旋转轴延伸并且其尺寸被调整为用于插入到所述多个模块区段的所述安装端口中，所述凹槽被配置成与所述安装端口内的所述制动装置配合，
其中通过围绕所述旋转轴旋转所述插入工具，所述尖端部分是从所述安装端口中的相应一个安装端口可选择性地释放的。
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