CN1838918A - 用于弹性地稳定椎骨体的装置 - Google Patents

用于弹性地稳定椎骨体的装置 Download PDF

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CN1838918A
CN1838918A CNA038271117A CN03827111A CN1838918A CN 1838918 A CN1838918 A CN 1838918A CN A038271117 A CNA038271117 A CN A038271117A CN 03827111 A CN03827111 A CN 03827111A CN 1838918 A CN1838918 A CN 1838918A
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longitudinal axis
spring
elastic device
axis
described device
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CN100435746C (zh
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S·哈特曼
A·施图德
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AO Technology AG
Synthes GmbH
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7026—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/60—Surgical 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 for external osteosynthesis, e.g. distractors, contractors
    • A61B17/64—Devices extending alongside the bones to be positioned
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/60—Surgical 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 for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66—Alignment, compression or distraction mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7026—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form
    • A61B17/7028—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form the flexible part being a coil spring
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7011—Longitudinal element being non-straight, e.g. curved, angled or branched

Abstract

本发明涉及一种用于弹性地稳定椎骨体的装置(1)，它具有：A)至少两个各具有一个中心轴线(3)和一个头段(4)的骨锚定件(2)；以及B)弹性装置(5)，它们具有一个纵轴线(12)并且可以与两个相邻骨锚定件(2)的头段(4)连接，使得纵轴线(25)横向于中心轴线(3)；其中C)所述弹性装置(5)在受压力载荷时具有渐进的弹簧特性曲线(20)；D)所述弹性装置(5)由一种金属材料制成；并且E)包括弹簧圈(19)，其中至少两个弹簧圈(19)具有一个相互不同的几何尺寸。

Description

用于弹性地稳定椎骨体的装置
技术领域
本发明涉及一种按权利要求1前序部分所述的用于弹性地稳定椎骨体的装置。
背景技术
在治疗受损伤或者有肿瘤的椎骨体时，通常使用借助于骨锚定件例如椎弓根螺钉或者椎弓根钩锚定在椎骨体上的刚性纵向支架。通过这种方式可以防止被稳定的椎骨体之间的相对运动，从而促进相邻椎骨体的融合。
在FR-A-2 799 949 BENAZZA中公开了一种脊柱固定装置，它由许多郁金香形的椎弓根螺钉组成，这些椎弓根螺钉代替普通的刚性纵向支架与一些单个的螺旋弹簧元件相互连接。虽然螺旋弹簧的长度可以调节，但由此只能实现螺旋弹簧元件预紧力的改变。
在EP-A-0 516 567 NAVAS中公开了另一种脊柱固定装置，它由许多郁金香形的椎弓根螺钉组成，这些椎弓根螺钉代替普通的刚性纵向支架与一些单个的阻尼元件相互连接。这种阻尼元件的缺点是其由生物相容的材料制造，因此阻尼元件具有一条线性的弹簧特性曲线。
在EP 0 677 277 MOREAU中公开了另一种脊柱固定装置，它具有许多椎弓根螺钉和平行于脊柱纵轴线布置在每两个椎弓根螺钉之间的弹性连接件。这种公开的装置包括具有渐进的(progressiv)弹簧特性曲线的弹性连接件。弹性装置包括一个螺旋弹簧，其中心孔填充有一种粘弹性材料。这种公开的装置的缺点是，由于弹性装置的这种带两个具有不同弹簧率的元件的构造，这种弹性装置的制造过程是非常昂贵的。
发明内容
本发明在此提供救济。本发明的任务是，提供一种用于稳定椎骨体的装置，它只包括一个由一种金属材料制成的弹簧元件，该弹簧元件具有一条在受压力载荷时渐进的弹簧特性曲线。
本发明通过具有权利要求1所述特征的用于弹性地稳定椎骨体的装置来解决该任务。
通过本发明所实现的优点主要在于，借助本发明的装置：
-在小的压力的情况下保证了足够大的弹性柔度和阻尼。由此实现了脊柱在该区域中足够大的运动自由性；
-在高的压力载荷或者冲击载荷的情况下，不必有用于吸收压力的大的弹簧变形量，因此可以避免背面元件的过载；
-使用一个唯一的由一种生物相容的金属材料、例如由钛制造的弹簧元件可以实现一条连续渐进的弹簧特性曲线。
在一种优选的实施方式中，弹性装置的弹簧特性曲线在力-变形量曲线图中具有一个连续渐进的走向。在此，该弹性装置优选构成为具有变化的弹簧圈节距的螺旋弹簧。
具有渐进的弹簧率的螺旋弹簧的其它改进方案例如这样实现：
-制造一种螺旋弹簧，该螺旋弹簧平行于纵轴线测量至少在两个相邻的弹簧圈之间具有一个不同的缝隙宽度x；或者
-由一种弹簧材料制造螺旋弹簧，该弹簧材料的正交于纵轴线的横截面平行于纵轴线测量在至少两个相邻的弹簧圈之间具有一个不同的高度h。
在另一种实施方式中，弹性装置构成为平面的、蛇曲形的、具有多个沿着纵轴线依次布置的弹簧圈的弹簧，其中每个弹簧圈具有一个带有一弯曲轴线的弯转环。
根据该实施方式，弯曲轴线和纵轴线之间的距离L在纵轴线的两侧是恒定的，或者弹簧圈可以这样设计，使得在所述至少一个设置在纵轴线左侧的弯曲轴线和该纵轴线之间的距离L1与在所述至少一个设置在纵轴线右侧的弯曲轴线和该纵轴线之间的距离L2相比是不同的。
在另一实施方式中，每个弹簧圈包括限动器，所述限动器限制相应弹簧圈的允许的弹簧变形量。优选每个弹簧圈的限动器包括至少一个凸块，所述凸块限制相应弹簧圈的弹簧变形量s。
通过凸块的构造可以使由所述至少一个凸块限制的弹簧变形量s对于至少两个弹簧圈是不同的。
蛇曲形的弹簧可以具有n个弹簧圈，其中每个弹簧圈具有不同的弹簧率(Federrate)i，也就是说例如i1＜ij＜in。
在又一实施方式中，至少两个弯转环的弹簧材料的壁厚是不同的，因此对于这两个弹簧圈来说弹簧率是不同的。
在另一实施方式中，弹性装置在其轴向的外端包括连接件，所述连接件适用于将弹性装置固定在骨锚定件上。例如这两个连接件中的一个可以由与纵轴线同轴的杆构成，而第二连接件可以构成为具有一个与纵轴线同轴的、用于容纳杆形纵向支架的中心孔的套筒。另一方面也可以是至少一个连接件，它借助于一个铰链连接可以与一个例如杆形的纵向支架连接。
附图说明
下面借助多个实施例的部分示意性的视图对本发明以及本发明的改进方案进行详细的说明。附图示出：
图1按本发明的用于稳定多个椎骨体的装置的一个实施例；
图2按本发明装置的一个实施例的弹性装置的纵向剖视图；
图3按本发明装置的另一实施例的弹性装置的视图；
图4在图2中所示的按本发明装置的实施例的弹性装置的以力-变形量图形式的弹簧特性曲线。
具体实施方式
图1中示出了用于稳定相邻椎骨体6的装置1的一个实施例。多个例如构造成椎弓根螺钉的骨锚定件2拧入待连接的椎骨体6的椎弓根中，使其中心轴线3横向于脊柱纵轴线布置。骨锚定件2的头段4与骨锚定件2的中心轴线3同轴布置并且具有横向于中心轴线3延伸的通道7。在这些通道7中可以插入弹性装置5的杆形连接部分8，使得在这里构造成螺旋弹簧的弹性装置5，在其借助于设置在头段4中的螺钉10相对于骨锚定件2被固定之前，可以相对于通道7且平行于脊柱纵轴线移动。弹性装置5关于其纵轴线12可以轴向和弹性弯曲地变形，使得骨锚定件2的弹簧变形量s(图4)同样平行于纵轴线25。两个轴向外侧的弹性装置5配有按图2所示实施例的连接件16a、16b，而中间的弹性装置5包括两个杆状的、同轴的连接件16a(图2)。
在图2中示出了作为螺旋弹簧11的弹性装置5的实施方式，其弹簧材料具有一个与纵轴线12正交的矩形横截面13，其中横截面13平行于纵轴线12测量具有变化的高度h。通过弹簧材料的横截面13的朝螺旋弹簧11的端部14、15逐渐增加的高度h得到同样朝螺旋弹簧11的端部14、15逐渐增加的弹簧圈的节距δ。在这里所示的实施例中，缝隙宽度x在螺旋弹簧11的整个长度上保持恒定。螺旋弹簧11具有与纵轴线12正交的圆环形横截面，并且在其两个与纵轴线12相交的端部14、15分别具有一个用于将螺旋弹簧11固定在骨锚定件2上的连接件16(图1)。设置在螺旋弹簧11第一端部14上的第一连接件16a设计成与纵轴线12同轴的杆8，而设置在螺旋弹簧11第二端部15上的第二连接件16b设计成套筒17并且包括一个与纵轴线12同轴的中心孔18。这两个连接件16与螺旋弹簧11固定连接。通过螺旋弹簧11的弹簧圈19的变化的节距δ实现了渐进的弹簧特性曲线。为了将杆形的部件固定在中心孔18中，设置了一个固定螺钉25，它可以拧入一个具有互补内螺纹27的、具有横向于纵轴线12的孔轴线28的孔26中，并且该固定螺钉25可以以其前端部压在一根插入中心孔18中的杆上(未示出)。
图3示出了弹性装置5的一个实施例，它包括一个弹簧29，该弹簧具有多个位于一个平面中的弹簧圈19。三个圈19a、19b、19c中每一个都具有一个受载弯曲的弯转环21以及限动器22。这里该限动器22分别由两个凸块23构成，这些凸块在每个圈19达到允许的弹簧变形量后相互贴靠并阻止相关圈19的进一步弹性变形。三个弹簧圈19a、19b、19c的弯转环21各具有一个弯曲轴线24a、24b、24c，其中纵轴线12左侧的影响弯曲的杠杆臂的长度L1大于纵轴线12右侧的影响弯曲的杠杆臂的长度L2。代替不同长度的杠杆臂，每个弹簧圈19的由限动器22允许的弹簧变形量si也可以是不同的。类似于图2中所示的实施例，弹簧29在其两个与纵轴线12相交的端部34、35各有一个适用于将弹性装置5固定在骨锚定件2上的连接件16(图1)。设置在弹簧29第一端部34上的第一连接件16a设计成与纵轴线12同轴的杆8，而设置在弹簧29第二端部35上的第二连接件16b设计为套筒17并且包括一个与纵轴线12同轴的中心孔18。这两个连接件16与弹簧29固定连接。为了将杆形部件固定在中心孔18中，设置一个固定螺钉(未示出)，它可以拧入一个具有互补内螺纹27的、具有横向于纵轴线12的孔轴线28的孔26中，并且该固定螺钉可以以其前端部压在一根插入中心孔18的杆上(未示出)。
在图4a中以力-变形量曲线图示出了在图2中所示出的弹性装置5的实施例的弹簧特性曲线20。该弹簧特性曲线20在整个弹簧变形量上都是渐进的。这种弹簧特性曲线20例如可以通过将弹性装置5构造成具有沿着纵轴线12连续变化的节距δ的螺旋弹簧11来实现。
图4b中示出的弹簧特性曲线20可以通过将弹性装置5构成为蛇曲形弹簧29来实现。按图4b的弹簧特性曲线20是不平滑的，并且在弹簧变形量s＝s1时具有一个转折点，它例如可以通过弹簧圈19的限动器22的闭合来实现。

Claims (18)

1.用于弹性地稳定椎骨体的装置(1)，具有：
A)至少两个各具有一个中心轴线(3)和一个头段(4)的骨锚定件(2)；以及
B)弹性装置(5)，它们具有一个纵轴线(12)并且可以与两个相邻骨锚定件(2)的头段(4)这样连接，使得纵轴线(25)横向于中心轴线(3)；其中
C)所述弹性装置(5)在受压力载荷时一种具有渐进的弹簧特性曲线(20)；
其特征在于：
D)所述弹性装置(5)由一种金属材料制成；并且
E)包括弹簧圈(19)，其中至少两个弹簧圈(19)具有至少一个相互不同的几何尺寸。
2.按权利要求1所述的装置(1)，其特征在于：所述弹性装置(5)的弹簧特性曲线(20)在力-变形量曲线图中具有连续渐进的走向。
3.按权利要求2所述的装置(1)，其特征在于：所述弹性装置(5)构成为具有变化的弹簧圈(19)节距δ的螺旋弹簧(11)。
4.按权利要求3所述的装置(1)，其特征在于：所述螺旋弹簧(11)平行于纵轴线(12)测量至少在两个相邻的弹簧圈(19)之间具有一个不同的缝隙宽度x。
5.按权利要求3或4所述的装置(1)，其特征在于：所述螺旋弹簧(11)由一种弹簧材料制成，该弹簧材料的与纵轴线(12)正交的横截面(13)平行于纵轴线(12)测量在至少两个相邻的弹簧圈(19)之间具有一个不同的高度h。
6.按权利要求1所述的装置(1)，其特征在于：所述弹性装置(5)构成为平面的、蛇曲形的、具有多个沿着纵轴线(12)依次布置的弹簧圈(19)的弹簧(29)。
7.按权利要求6所述的装置(1)，其特征在于：每个圈(19)具有一个带有一弯曲轴线(24)的弯转环(21)。
8.按权利要求7所述的装置(1)，其特征在于：在所述弯曲轴线(24)和纵轴线(12)之间的距离L在纵轴线(12)两侧是恒定的。
9.按权利要求7所述的装置(1)，其特征在于：在所述至少一个设置在纵轴线(12)左侧的弯曲轴线(24a)和纵轴线(12)之间的距离L1与在所述至少一个设置在纵轴线(12)右侧的弯曲轴线(24b)和纵轴线(12)之间的距离L2相比是不同的。
10.按权利要求6至9中任一项所述的装置(1)，其特征在于：每个弹簧圈(19)包括限动器(22)，所述限动器限制相应弹簧圈(19)的允许的弹簧变形量。
11.按权利要求10所述的装置(1)，其特征在于：每个弹簧圈(19)的限动器(22)包括至少一个凸块(23)，所述凸块限制相应弹簧圈(19)的弹簧变形量s。
12.按权利要求11所述的装置(1)，其特征在于：由所述至少一个凸块(23)限制的弹簧变形量s对于至少两个弹簧圈(19)是不同的。
13.按权利要求6至12中任一项所述的装置(1)，其特征在于：所述蛇曲形弹簧(29)的弹簧特性曲线包括n个弹簧圈(19)，并且对于每个弹簧圈(19)都具有一个弹簧率i，其中i1＜ij＜in。
14.按权利要求7至13中任一项所述的装置，其特征在于：在至少两个弯转环(21)之间的弹簧材料的壁厚是不同的。
[优点：所述弹性装置可以设计成可简单制造的蛇曲形。]
15.按权利要求1至14中任一项所述的装置(1)，其特征在于：所述弹性装置(5)在其端部(3、4)包括连接件(16)，这些连接件适用于将弹性装置(5)固定在骨锚定件(2)上。
16.按权利要求15所述的装置(1)，其特征在于：至少一个连接件(16a)是一个与纵轴线(25)同轴的杆(8)。
17.按权利要求15或16所述的装置(1)，其特征在于：至少一个连接件(16b)是一个具有一与纵轴线(12)同轴的中心孔(18)的套筒(17)。
18.按权利要求15至17中任一项所述的装置(1)，其特征在于：至少一个连接件(16)包括一个铰链连接。
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CN103040510A (zh) * 2011-02-17 2013-04-17 上海微创骨科医疗科技有限公司 一种脊柱动态连接棒
CN103040510B (zh) * 2011-02-17 2015-01-21 上海微创骨科医疗科技有限公司 一种脊柱动态连接棒
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