CN1758888A - 椎间盘假体或椎间假体 - Google Patents

椎间盘假体或椎间假体 Download PDF

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Publication number
CN1758888A
CN1758888A CNA038262053A CN03826205A CN1758888A CN 1758888 A CN1758888 A CN 1758888A CN A038262053 A CNA038262053 A CN A038262053A CN 03826205 A CN03826205 A CN 03826205A CN 1758888 A CN1758888 A CN 1758888A
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CN
China
Prior art keywords
intervertebral disk
disk prosthesis
flexible member
approximation
plates
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
Application number
CNA038262053A
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English (en)
Inventor
A·施图德
J·特拉赫塞尔
M·维曼
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AO Technology AG
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Synthes AG Chur
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Filing date
Publication date
Application filed by Synthes AG Chur filed Critical Synthes AG Chur
Publication of CN1758888A publication Critical patent/CN1758888A/zh
Pending legal-status Critical Current

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    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Abstract

椎间盘假体或椎间假体，具有：A)一适合于贴靠到一椎骨体的底板上的上对合板(1)；B)一离它一定距离的适合于贴靠到椎骨体的顶板上的下对合板(2)；C)多个设置在两块对合板(1，2)之间在其外围区域(4)内的弹性元件(3)，使得两块对合板(1，2)可相互相对弹性运动；D)一基本上垂直于两块对合板(1，2)的中心线(5)；其中弹性元件(3)设计成这样或这样设置，使椎间盘假体总体具有非对称的刚性。

Description

椎间盘假体或椎间假体
技术领域
本发明涉及一种按权利要求1前序部分的椎间盘假体或椎间假体。这些假体可以做成核置换物、柔性的护圈(笼)或内部的椎间盘假体，它们可以从后面装入(PLIF技术)。作为动力植入物，它们也可以固定在相邻椎骨体的棘突之间。
背景技术
由US-A-5458642 BEER ETAL已知一种椎间盘假体，带一上、下腰子形板，它们在其外围(围绕一中央芯部)通过大量相同的螺旋弹簧相互连接。螺旋弹簧相互按规则间距设置，并允许两块板在一定限度内作三维运动。这种已知椎间盘假体的缺点是这样的情况，即植入物在每个半径方向的刚性—在离植入物中心相同的距离时—是相同的，亦即植入物具有对称的刚性。
发明内容
这里本发明将提出解决办法。本发明的目的是，创造一种椎间盘假体，它具有非对称的刚性，这有这样的优点，即椎间盘假体可以用结构方法调整到一种生理性能，使得例如在脊柱向后伸展时植入物存在比在向侧前方侧向运动时大的刚性。
本发明用具有权利要求1特征的椎间盘假体实现所提出的目的。
通过本发明达到的优点主要是，由于本发明的椎间盘假体在脊柱受力时可以达到一种生理性能，特别是通过非对称的刚性变化可以控制植入物的回转点。
在一种优选实施形式中弹性元件的数量在4至12个，尤其是6至10个的范围内。
在另一种实施形式中弹性元件相互一样，但是径向不均匀地设置在椎间盘假体的外围区域内。由此可以达到这样的优点，即通过外围每度上相同弹性元件的可变数量或者通过相同弹性元件不规则的(亦即较密或不太密的)布局，可以可选择地在生产时调整椎间盘假体的刚性，使得根据半径方向产生椎间盘假体不同的刚性，因此它比在具有对称刚性的普通椎间盘假体的情况下更好地适应人体构造状况。
在另一种实施形式中弹性元件的至少一部分设计得相互不同，这时弹性元件最好径向均匀地设置在椎间盘假体的外围区域内。
在又一种实施形式中弹性元件的至少一部分设计得相互不同，这时弹性元件径向不均匀地设置在椎间盘假体的外围区域内。
在另一种实施形式中椎间盘假体至少在90°外围圆弧的一部分区域内具有比互补的90°外围圆弧内高的刚性。
在另一种实施形式中弹性元件的至少一部分由不同刚性的不同材料组成。
所有已知的金属和聚合的天然植入物材料适合于作为植入物材料。植入物也可带HAC涂层。
植入物的优选材料是：钛、Nitinel、钛合金和钢。优选材料组合如下：
—对于对合板：钛/钛合金
—对于中间板：钛/钛合金
—对于螺钉：钛
—对于环：Nitinel、钛或钢
对合板的几何形状和表面适宜于与椎骨体的自然端板匹配，这两块对合板在不同的实施形式中可以设计成圆环形、矩形、腰子形、椭圆形或螺旋形。
在另一种实施形式中弹性元件设计成环或部分环，其中设计成这样的弹性元件的环平面的布局可以这样进行，
—环平面与椎间盘假体的中心线相交；
—环平面与椎间盘假体的中心线不相交；
—环平面基本上垂直于两个对合板分布；或
—环平面倾斜于两个对合板。
在另一种实施形式中至少一部分环具有不同的刚性，其中环的布局最好顺序地以越来越大或越来越小的刚性进行。
在另一种实施形式中环设置在外围，由此可以达到这样的优点，由此使外围部分区域具有较高的刚性，部分区域具有较低的刚性。
在不同实施形式中弹性元件可以由以下一些组中选取：螺旋弹簧、弹性囊(Federbalg)、塑料柱(Kunststoffzylinder)、带、钢丝网编织物、环形纤维或塑料涂覆的钢丝。由此与设计成环的弹性元件相比可达到如下优点：
—更高的柔性；
—较简单的生产专门知识；
—较简单的操作；以及
—椎间盘假体的粘弹性性能。
在另一种实施形式中弹性元件由尤其是做成单丝的钢丝绳组成。
在又一种实施形式中弹性元件包括至少一个弹簧件，它由设计如下的弹簧钢丝组成：
—弹簧钢丝具有蛇形曲线；和/或
—弹簧钢丝具有至少一个回环。
在又一种实施形式中椎间盘假体包括一由塑料材料组成的芯部。由此可达到这样的优点，即椎间盘假体具有粘弹性特性，并在相邻椎骨体运动时进行更好的缓冲。
在另一种实施形式中椎间盘假体在外围处的可压缩性至少为0.7mm，尤其至少为1.0mm，最多为1.2mm，尤其最多为3.5mm。
弹性元件与对合板的连接可以设计成形锁合或力锁合的。
在另一种实施形式中两块对合板相互夹一10°至14°的角。
在又一种实施形式中弹性元件连接成一个单元，两块对合板可推到或卡扣到该单元上。
附图说明
下面借助于多个实施例的部分示意图更详细地说明本发明和本发明的改进结构。
附图表示：
图1   一椎间盘假体的透视图；
图2   按图1的椎间盘假体的侧视图；
图3   按图1的椎间盘假体的俯视图；
图4a  椎间盘假体另一实施形式的侧视图；
图4b  图4a中所示的椎间盘假体的实施形式不带上对合板的俯视图；
图4c  在图4a中所示的椎间盘假体的一种实施形式的透视图；
图4d  在图4a至4c中所示的椎间盘假体的实施形式的不带上对合板的透视图；
图5a  椎间盘假体的另一种实施形式的不带上对合板的正视图；
图5b  在图5a中所示的椎间盘假体的实施形式的俯视图；
图5c  在图5a和5b中所示的椎间盘假体的实施形式的侧视图；
图5d  在图5a至5c中所示的椎间盘假体的实施形式的透视图；
图6a  椎间盘假体另一种实施形式的正视图；
图6b  图6a中所示的椎间盘假体的实施形式的B-B剖视图；
图6c  在图6a和6b中所示的椎间盘假体的不带上对合板的实施形式的与下对合板连接的弹性元件的透视图；
图6d  图6a至6c中所示的椎间盘假体的实施形式的透视图；
图7a  椎间盘假体另一种实施形式的俯视图；
图7b  图7a中所示的椎间盘假体的实施形式的B-B剖视图；
图7c  图7a和7b中所示的椎间盘假体的实施形式的侧视图；
图7d  在图7a至7c中所示的椎间盘假体的实施形式的透视图；
图8   两个植入在两个椎骨体之间的如图7a至7d中所示的椎间盘假体的示意图；
图9   带有两个如图7a至7d中所示的椎间盘假体的椎骨体的盖板平行于脊柱纵轴的俯视图；
图10  两个植入在两个椎骨体之间的如图7a至7d所示的椎间盘假体的腹向视图；
图11  本发明椎间盘假体的弹性元件的另一种实施形式的正视图。
具体实施方式
在图1至3中所示的椎间盘假体由一适合于贴靠到椎骨体的底板上的圆环形上对合板1、一和它离开一定距离的适合于贴靠到椎骨体的盖板上的圆环形下对合板2、两个设置在这两个对合板1、2之间的同样做成圆环形的中间板6组成，其中所有板沿一共同中心线5与它正交地设置。
在两个圆环形对合板1、2之间设置总共八个环3a-3h形状的弹性元件3，它们径向于中心线5设置，并且其中其环平面垂直于对合板1、2设置。
为了使椎间盘假体固定在一起，上对合板1与相邻中间板6通过总共八个螺钉7连接，同样下对合板2与相邻中间板6通过总共八个螺钉7连接。为此对合板1、2具有用来容纳螺钉头的相应的孔9，中间板6具有用来安装螺钉杆的相应螺纹孔。螺钉7这样设置，使它们分别分布在两个相邻环之间。
这里各个环3a-3h被这样形成的上板对1、6和下板对2、6径向夹住，使得两个板对1、6和2、6通过环3a-3h相互连接，并由于圆环3a-3h的弹性可以从在未受力状态下的平行布置一在一定限度(在外围处的可压缩性为约1.0至1.5mm)内一相互倾斜。由此可以使两块对合板1、2相互夹一约12°的角。
为了使椎间盘假体的结构高度做得小，对合板1、2和中间板6在环3a-3h的通孔区域内可以具有相应于环3a-3h轮廓的孔8。
在外围按45°的规则间距设置的弹性环3a-3h具有不同的弹性和刚性，它们可以通过圆环不同的材料、不同的几何形状或环不同的轮廓(实心、空心、圆形、矩形)达到。由此在具有环3b、3c和3d的区域内得到比具有环3f、3g和3h的区域内高的刚性。因此在垂直于对合板1施加一定的力时在圆环3c区域上产生比在使用同样大的力时在圆环3g区域上小的压缩量(两块对合板1、2靠近)。由于这种非对称特性，可以通过这样的方法达到椎间盘假体更好的生理特性，即在脊柱向前弯曲时圆环3f、3g和3h的压缩量比在脊柱向后弯曲时更大，向后弯曲压缩圆环3b、3c和3d。
各个圆环的弹性系数适宜于在50％至100％之间变化，按数值而言弹性系数可以在300N/mm至1000N/mm之间。
在图4a至4d中表示一种实施形式，其中弹性元件3包括一螺旋弹簧10，其纵轴11在一与中心线5正交的平面内形成圆形，因此螺旋弹簧10以360°角围绕植入物的中心线5。这里螺旋弹簧10相对于圆形对合板1、2的外围向外移出这么远，使它们略微突出于对合板1、2的外围。螺旋弹簧10具有两个具有相反导程的弹簧钢丝绕圈的圆弧形部分。在两个部分的连接部位螺旋弹簧10的绕圈分别通过一个回环12；13相互连接。这里回环12；13设置在螺旋弹簧10的朝向上对合板1的圆弧段处。由于螺旋弹簧10的带有两个具有相反导程的圆弧形部分的结构可以控制植入物的扭转刚性。在对合板1；2相互面对面的内表面上设有与中心线5同心的圆环形凸起19；20。弹簧钢丝在各个绕圈穿过两个圆环形凸起19；20之一上的孔各一次，使对合板1；2和螺旋弹簧10固定在一起。其次两个回环12；13在它们在两个相互邻接的弹簧钢丝绕圈之间占有的距离方面设计得各不相同。螺旋弹簧10的绕圈在螺旋弹簧10的两个圆弧形部分上具有恒定的导程，因此植入物的弹性系数仅仅在螺旋弹簧10的两个圆弧形部分的连接部位处具有不同的值。通过将螺旋弹簧10设计成带具有相反导程的绕圈的两个部分可以达到，植入物在两个旋转方向的扭转刚性一样大。
在图5a至5d中所示的实施形式与在图4a至4d中所示的实施形式的区别仅仅在于，对合板1；2(仅仅画出一个对合板2)设计成椭圆形，因此弹性元件3包围四个圆弧形的设置在一椭圆形纵轴14上的但是分开的螺旋弹簧件15；16；17；18。其中每两个相互径向面对面的螺旋弹簧件15；16；17；18设计得相互镜像对称，其中两个镜像对称设置的螺旋弹簧件15；16具有带相反导程的绕圈，另两个镜像对称设置的螺旋弹簧件17；18分别在其中心具有一回环12；13，以此改变绕圈的旋转方向。其次面对镜像对称设置的螺旋弹簧件15；16；17；18的导程不同，因此弹性元件3的弹性系数根据转轴的位置在两个与两对合板1；2的外表面相邻的椎骨体34；35(图8ff)之间是不同的。
在图6a至6d中表示一种实施形式，其弹性元件3的结构与在图4和5中所示的结构相比区别仅仅在于，它包括两个与中心线5同心的弹簧件22；23，它们分别具有一具有多个蛇形曲线24的弹簧钢丝25。弹簧件22、23具有部分环面形状，其中在蛇形曲线24的回环12；13之间的连接段倾斜于环面的经线分布。其中环面的经线和蛇形曲线24的回环12；13之间的连接段之间的夹角对于两个弹簧件22、23大小相同、方向相反。此外每个对合板1；2具有两个与中心线5同心的凸起19’；19”；20’；20”。蛇形曲线24的各一个回环12与按图4的实施例相似穿过上对合板1上圆环形凸起19之一上的两个孔，而蛇形曲线24的另一个回环13穿过下对合板2上的圆环形凸起20之一上的两个孔，使得两块对合板1；2和弹性元件3固定在一起。其中内弹簧件22的回环12；13穿过内凸起19’、20’上的孔，外弹簧件23的回环12；13穿过外凸起19”、20”上的孔。
在图7a至7d中表示一种实施形式，它包括带有与中心线5垂直的矩形表面的上、下各一个对合板1；2。两个依次设置在对合板1；2之间的螺旋弹簧件15；16的纵轴11平行于矩形对合板1；2的长轴。两个螺旋弹簧件15；16具有相互反向的绕圈导程。其次在两个对合板1；2的位于内部的表面上设有与长轴平行的凸起19；20，它们具有横向于长轴分布的孔。因此螺旋弹簧件15；16穿过孔的绕圈将两块对合板1；2固定在一起。
在图8至10中表示如图7a至7d中所示的两个椎间盘假体的应用。两个椎间盘假体这样地插入两个相互邻接的椎骨体34；35的椎间腔内，使螺旋弹簧件15；16的纵轴11从前面到后面延伸，其中在脊柱纵轴侧面各设置一个椎间盘假体。通过椎间盘假体的这种布局，对于脊柱的弯曲/伸展和侧向弯曲得到弹性元件3的不同弹性系数。
在图11中表示弹性元件3的实施形式，它包括一卷绕成回环26的弹簧钢丝25。弹簧钢丝25上的回环26一方面可以设计成这样，即与图1中所示的环类似回环26是封闭的并形成单个弹簧件，它们以希望的形状分布在对合板1；2之间。另一方面可以类似于在图4中所示的实施形式将回环26做成螺旋弹簧式弹簧件的绕圈。弹簧钢丝25在对合板1；2上的固定可以按图1至10中所示实施例的任一种进行。此外对合板1；2的结构以及弹性元件3的分布可以按图1至10中所示的实施形式的任一种进行。

Claims (26)

1.椎间盘假体或椎间假体，具有
A)一适合于贴靠到一椎骨体的底板上的上对合板(1)；
B)一与它离开一定距离的、适合于贴靠到一椎骨体的顶板上的下对合板(2)；
C)多个弹性元件(3)，它们设置在两个对合板(1；2)之间其外围区域(4)内，使这两个对合板(1；2)可相对弹性运动；以及
D)一中心线(5)，它基本上垂直于两块对合板(1；2)；
其特征在于：
弹性元件(3)设计成这样，或这样设置，使椎间盘假体总体上具有一非对称的刚性。
2.按权利要求1的椎间盘假体，其特征为：弹性元件(3)的数量在4-12个，尤其是6-10个的范围内。
3.按权利要求1或2的椎间盘假体，其特征为：弹性元件(3)相互相同、但径向不均匀地设置在外围区域(4)内。
4.按权利要求1或2的椎间盘假体，其特征为：所述弹性元件(3)的至少一部分各不相同，并最好径向均匀地设置在外围区域(4)内。
5.按权利要求1或2的椎间盘假体，其特征为：所述弹性元件(3)的至少一部分各不相同，并径向不均匀地设置在外围区域(4)内。
6.按权利要求1至5之任一项的椎间盘假体，其特征为：它至少在一90°圆弧的分区内具有比在互补的90°圆弧内高的刚性。
7.按权利要求1至6之任一项的椎间盘假体，其特征为：所述弹性元件(3)的至少一部分由不同刚性的不同材料组成。
8.按权利要求1至7之任一项的椎间盘假体，其特征为：所述两个对合板(1；2)设计成圆环形。
9.按权利要求1至8之任一项的椎间盘假体，其特征为：弹性元件(3)是环或部分环。
10.按权利要求9的椎间盘假体，其特征为：做成环或部分环的弹性元件(3)的环平面与中心线(5)相交。
11.按权利要求9的椎间盘假体，其特征为：做成环或部分环的弹性元件(3)的环平面与中心线(5)不相交。
12.按权利要求9至11之任一项的椎间盘假体，其特征为：环平面基本上垂直于两块对合板(1；2)分布。
13.按权利要求9至11之任一项的椎间盘假体，其特征为：环平面基本上倾斜于两块对合板(1，2)分布。
14.按权利要求9至13之任一项的椎间盘假体，其特征为：所述环的至少一部分具有不同的刚性，尤其是按顺序以逐渐增加或逐渐减小的刚性设置。
15.按权利要求14的椎间盘假体，其特征为：所述环设置在外围上。
16.按权利要求1至8之任一项的椎间盘假体，其特征为：弹性元件(3)从以下组中选择：螺旋弹簧、弹性囊、塑料柱、带、钢丝网编织物、环形纤维和塑料涂覆的钢丝。
17.按权利要求1至8之任一项的椎间盘假体，其特征为：弹性元件(3)由一钢丝绳组成，它最好设计成单丝。
18.按权利要求1至8之任一项的椎间盘假体，其特征为：弹性元件(3)包括至少一个弹簧件(22、23)，它由一具有蛇形曲线(24)的弹簧钢丝组成。
19.按权利要求1至8之任一项的椎间盘假体，其特征为：弹性元件(3)包括至少一个由一具有至少一个回环(26)的弹簧钢丝(25)组成的弹簧件。
20.按权利要求1至19之任一项的椎间盘假体，其特征为：它具有一由塑料材料组成的芯部。
21.按权利要求1至20之任一项的椎间盘假体，其特征为：所述两块对合板(1，2)设计成腰子形、椭圆形或螺旋形。
22.按权利要求1至21之任一项的椎间盘假体，其特征为：它在外围处的压缩性至少为0.7mm，尤其是至少为1.0mm。
23.按权利要求1至22之任一项的椎间盘假体，其特征为：它在外围处的压缩性至多为1.2mm，尤其是至多为3.5mm。
24.按权利要求1至23之任一项的椎间盘假体，其特征为：弹性元件(3)与两个对合板(1，2)形锁合或力锁合连接。
25.按权利要求1至24之任一项的椎间盘假体，其特征为：所述两块对合板(1，2)相互夹一10°至14°的角。
26.按权利要求1至25之任一项的椎间盘假体，其特征为：弹性元件(3)连接成一个单元，两块对合板(1，2)可推到或卡扣到该单元上。
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US7628814B2 (en) 2009-12-08
US20060052872A1 (en) 2006-03-09
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ATE444039T1 (de) 2009-10-15
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