CN1913846B - 椎间盘假体 - Google Patents

椎间盘假体 Download PDF

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Publication number
CN1913846B
CN1913846B CN2005800039443A CN200580003944A CN1913846B CN 1913846 B CN1913846 B CN 1913846B CN 2005800039443 A CN2005800039443 A CN 2005800039443A CN 200580003944 A CN200580003944 A CN 200580003944A CN 1913846 B CN1913846 B CN 1913846B
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CN
China
Prior art keywords
plate
pellet
intervertebral disk
disk prosthesis
prosthesis according
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.)
Expired - Fee Related
Application number
CN2005800039443A
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English (en)
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CN1913846A (zh
Inventor
I·霍沃尔卡
P·伯纳德
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LDR Medical SAS
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LDR Medical SAS
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Priority to CN201010256654.2A priority Critical patent/CN101961270B/zh
Publication of CN1913846A publication Critical patent/CN1913846A/zh
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Publication of CN1913846B publication Critical patent/CN1913846B/zh
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Abstract

本发明涉及一种包括至少三个构件的椎间盘假体，至少三个构件包括顶板(1)、底板(2)和至少相对于所述底板(2)可活动的芯块(3)，所述芯块(3)的上表面至少与所述顶板(1)的下表面的一部分接触，配合装置(22，31)限制摩擦同时分别限制或防止芯块(3)相对于底板(2)沿着基本平行于所述底板(2)的轴线平移和绕基本垂直于所述底板(2)的轴线旋转，其特征在于，至少所述芯块(3)的下表面具有至少一个孔(41)，用于促进芯块(3)在与其相接触的底板(2)的上表面上滑动。

Description

椎间盘假体
技术领域
本发明涉及一种椎间盘假体，用于替换特别是在颈椎区域内的纤维软骨盘，以确保脊柱的椎骨之间的结合。
背景技术
在现有技术中已知有各种类型的假体。许多假体是由包围着中心芯块的底板和顶板构成。这些假体的一部分使所述顶板能够相对于中心芯块滑动并且可选择地允许中心芯块相对于底板滑动。中心芯块相对于底板的滑动是必要特征，因为在使用所述假体的病人运动过程中，这种滑动必须允许所述芯块在理想位置处自动定位，以吸收施加在该假体上的约束。但是，由于来自所施加约束的作用力、所使用的材料和构成所述假体的不同构件的形状，使所述芯块的滑动通常很困难，这导致快速磨损以及至少所述假体的一部分弹出脊柱之外的风险，而且，这对于病人来说是不够理想的。
发明内容
本发明的目的是通过提出一种椎间盘假体以消除现有技术的某些缺陷。该假体允许其不同构件有限制地彼此相互运动，但促进其芯块的滑动，以改善在对假体施加约束时假体的性能。
该目的通过一种椎间盘假体实现，该椎间盘假体包括至少三个部件，它们包括第一板、第二板和至少相对于其中一个板可移动的芯块，该芯块具有与第一板的互补曲面的至少一部分相接触的曲面以及与第二板的基本上平坦的表面的至少一部分相接触的基本上平坦的表面，位于第二板和芯块的周边附近的配合装置，允许以无过量摩擦的方式来限制或防止芯块相对于第二板沿基本上平行于所述基本平坦的表面的轴线平移并允许限制或防止芯块相对于第二板绕与其基本平坦的表面基本垂直的轴线旋转，其特征在于，至少所述芯块的基本平坦表面具有至少一个盲孔，以促进芯块相对于与其相接触的第二板的基本平坦表面滑动。
根据另一个特定特征，至少所述基本平坦的表面是芯块的下表面和称之为底板的第二板的上表面。
根据另一个特定特征，至少所述芯块的基本平坦的表面被包围在一保护壳内，其中与第二板的基本平坦表面和与芯块的基本平坦表面相接触的表面具有至少一个孔。
根据另一个特定特征，所述芯块的保护壳并不覆盖芯块的配合装置，从而避免保护壳与第二板的配合装置相接触。
根据另一个特定特征，在芯块的两侧，芯块或保护壳的基本平坦表面和第二板的基本平坦表面之间的接触面积与芯块的弯曲表面和第一板的弯曲表面之间的接触面积基本上相等。
根据另一个特定特征，由至少位于芯块或芯块的保护壳的基本平坦表面上的孔的边缘所形成的角被柔化，以改善芯块或保护壳在第二板的基本平坦表面上的滑动。
根据另一个特定特征，位于芯块或芯块保护壳的基本平坦表面上的孔被延长，通过槽形成通道直到该基本平坦表面的外围，其中，来自四周组织的间质液体可以通过该通道提供润滑作用，以在假体被植入病人时改善芯块在第二板的基本平坦表面上的滑动。
根据另一个特定特征，由将孔延长直到芯块或芯块保护壳的基本平坦表面的外围的所述槽的边缘形成的角被柔化，以改善芯块或保护壳在第二板的基本平坦表面上的滑动。
根据另一个特定特征，所述芯块由聚乙烯制成。
根据另一个特定特征，芯块的保护壳由金属制成。
根据另一个特定特征，第一板和第二板由金属制成。
根据另一个特定特征，所述配合装置包括第二板的凸起装置，该凸起装置与芯块的凹入装置相配合。
根据另一个特定特征，所述芯块相对于第一板和/或第二板是可活动的，并且第一板和第二板之间的可变角度取决于芯块的位置，至少第一板的任意方向上的倾斜导致芯块在板之间移动并向病人提供活动的自由，同时有助于消除假体的定位缺陷。
根据另一个特定特征，顶板的上表面与底板下表面之间的角度可以利用下列方式之一实现：通过代表芯块的上表面和下表面的平面装置形成角度，或通过代表第一板和/或第二板的上表面和下表面的平面装置形成一角度，或通过限制芯块绕使至少第一板倾斜的位置运动。
根据另一个特定特征，所述板可以与不同厚度的芯块组装在一起。
根据另一个特定特征，第一板的表面的至少一部分是凹入的，并且和与其接触的芯块的表面互补。
根据另一个特定特征，每个凸起装置的尺寸都稍微小于每个凹入装置的尺寸，从而在芯块和第二板之间允许有微量间隙。
根据另一个特定特征，每个凸起装置的尺寸与每个凹入装置的尺寸基本上相同，从而防止在芯块和第二板之间出现任何间隙。
根据另一个特定特征，所述第二板的凸起装置是彼此相对着位于假体的两个边缘上的两个接触板，芯块的凹入装置是两个槽。
根据另一个特定特征，所述第二板的凸起装置是彼此相对着位于假体的两个边缘附近的两个壁，芯块的凹入装置是槽。
根据另一个特定特征，底板的凸起装置是两个朝向假体内部弯曲并且彼此相对着位于假体的两个边缘上的凸块，而芯块的凹入装置是两个槽。
根据另一个特定特征，所述凸块的至少一个被设有孔的销取代，并且用穿过所述孔的销钉装置将一个板固定在所述销上。
根据另一个特定特征，底板的下表面和顶板的上表面设置有位于假体的至少两个边缘附近的齿或凹口，并且所述齿或凹口被定向成在假体连接到骨组织之前防止假体的滑动，其中，所述连接是由与椎骨接触的板表面的多孔的不排斥的覆层实现的。
根据另一个特定特征，至少所述第二板包括一个或多个位于其前侧附近的开口，用于接收椎骨中假体的锚固装置。
根据另一个特定特征，第二板的开口是圆形的，并且锚固装置具有柱头的形状。
根据另一个特定特征，所述锚固装置的头部尺寸比第二板的开口尺寸大，所述锚固装置被固定到椎骨中，所述第二板被夹在所述锚固装置的头部和所述椎骨之间。
根据另一个特定特征，顶板上表面的至少一部分凸出，以适应椎骨的形状。
本发明的另一个目的是提供一种在两椎骨之间的椎间盘假体的插入装置，椎间盘假体由底板、顶板和至少相对于所述底板可活动的芯块构成。它将有利于两椎骨之间的假体插入装置允许所述假体保持无菌，有利于将其对着两椎骨之间的外科手术形成的开口定位，有利于通过移动将其推入所述开口并随后将所述装置取出以使所述假体保持插入在开口中。
本目的通过一种位于两椎骨之间的椎间盘假体的插入装置实现，所述椎间盘假体由第一板、第二板和至少相对于第二板可活动的芯块构成，其特征在于，所述插入装置包括夹子，其中所述夹子的前表面具有用于配合假体前边缘形状的形状，并且夹子的至少两个边缘安装有假体夹紧装置。
根据另一个特定特征，所述位于夹子的至少两个边缘上的夹紧装置是两个安装在夹子侧边缘上的，并且通过夹紧假体的顶板和底板的侧边缘来保持所述假体的柔性叶片。
根据另一个特定特征，夹子的前表面具有用于配合假体前边缘形状的形状，一方面，由于其高度至少基本上等于所述假体的高度，从而与假体的每个板的前边缘接触，另一方面，由于至少在夹子的前表面的中部具有至少一个槽，同样与相对于板的前边缘稍微后置的芯块的前边缘接触。
根据另一个特定特征，夹子的后表面可由称为导杆的杆件的第一端推动，所述导杆安装有在其另一端的推进器和沿着导杆在可变位置的止动器，止动器用于限制导杆在加载器的本体内滑动长度，所述加载器配有头部，所述头部中设置有尺寸适于接收所述假体和夹子的空间，止动器在导杆上的位置是可调的，从而当止动器接触加载器的本体时，由夹子夹持的假体从加载器的本体中伸出并相对于假体要植入其间的两椎骨的垂直轴线对中。
根据另一个特定特征，位于夹子的至少两个边缘上的假体夹紧装置的前端大于其后端，在其后端处夹子的宽度基本上等于加载器的头部内的空间的宽度，因此，当假体和夹子位于加载器的头部内时，假体由夹子的夹紧装置紧紧地夹持住，然后夹子的夹紧装置被压缩在假体和布置在加载器的头部内的空间的内壁之间，当假体从加载器头部伸出时，它不是那么紧紧地被夹子夹持住，从而可以从夹子中释放。
附图说明
本发明的其它具体技术特征和优点将根据下文中参照附图的描述更加清楚地看出，其中：
图1A示出根据本发明一实施例的假体的正面透视图，图1B示出所述假体的顶视图，图1C和图1D分别为沿平面A-A和B-B的视图，
图2A示出本发明的一实施例中的配备有保护壳的芯块的顶视图，图2B和2C为沿平面A-A和B-B的视图，图2D和2E分别以透视图的方式示出安装有保护壳的芯块的顶视图和底视图，
图3A和3B分别以透视方式示出本发明一个实施例中的不具有保护壳的芯块的侧视图和顶视透视图，图3C和3D分别以透视方式示出本发明一个实施例中的芯块的保护壳的顶视图和底视图，
图4A示出假体的顶板的底视图，图4C和4D分别为沿平面A-A和B-B的视图，图4B示出根据本发明一个实施例的椎间盘假体的顶板的侧视图，
图5A示出假体的底板的顶视图，图5B和5C分别示出所述假体的底板的侧视图和前视图，图5D和5E分别以透视方式示出根据本发明一个实施例的椎间盘假体的底板的顶视图和底视图，
图6A示出位于两椎骨之间的椎间盘假体的插入装置的夹子的透视图，图6B和6C分别示出两椎骨之间的假体插入装置的推进器头部的局部侧视图和顶视图，其中假体被所述夹子夹持在延长位置，图6D示出两椎骨之间的椎间盘假体的插入装置的夹子的透视图。
图7A示出当由夹子夹持的假体缩入推进器头部时，位于两椎骨之间的完整的假体插入装置的顶视图，图7B根据图7A中的截面D-D示出上述假体插入装置，图7C示出当由夹子夹持的假体从推进器头部中伸出时的位于两椎骨之间的完整的假体插入装置的顶视图，图7D根据图7C中的截面D-D示出假体插入装置。
具体实施方式
如图1A、1C和1D所示，根据本发明的椎间盘假体由通过芯块(3)相对于第二板(2)铰接的第一板(1)构成。在以下说明中，根据附图中所示的假体的定向，第一板(1)被称为顶板，第二板(2)被称为底板。显然，在不背离本发明范围的情况下，此处的假体可以在椎骨之间相反地定向，这样，所述第一板(1)将会变成底板，而第二板(2)将会变成顶板(1)。根据本发明的假体的一个优点是它包括一些简单部件，这些部件的尺寸被确定成将该假体置于颈椎上。
芯块(3)具有很小的厚度(例如3mm)用于颈椎假体，或更厚(例如15mm)用于腰椎假体。
在变型实施例中，顶板(1)的上表面的一部分是凸出的，如图4B至4D所示，从而可以更好地适应于所述假体将要放置其上的椎骨，该椎骨的下表面是凹入的。该顶板(1)的凸出部分位于顶板的前部，具体如图4D所示。底板(2)基本上是平的。事实上，其底面没有必要凸出或凹陷，这是因为椎骨的上表面基本上是平的。
在图1A至1D、4B至4D和5B至5E所示的实施例中，顶板(1)的上表面和底板(2)的下表面具有位于假体的至少两个边缘区域内的齿或凹口(11，21)。当骨组织连接在所述板的这些表面与椎骨接触时，这些为防止假体滑动而定向的凹口(11，21)，用作假体的锚固装置。事实上，所述骨组织在植入这些假体的外科手术的几周后，就会侵入其所接触的那些表面。在这些表面上提供有一层多孔的不排斥的覆层，以允许骨组织连接并最终与假体相融合。
一个包括根据本发明的所有可能的元件的实施例将在下文中说明。在该实施例中，芯块(3)的下表面由一芯块保护壳(4)包围。在该保护壳(4)下表面的中心处例如钻出至少一个孔例如盲孔，以改善在底板(2)的上表面上的滑动。在一个更简单的变型实施例中，没有该保护壳(4)，例如在芯块(3)的下表面的中部穿有一个盲孔。该芯块本身具有与由芯块(3)和其保护壳(4)组成的组件基本上相同的形状，如同下文中所要说明的并在图2A至2E中所示出的实施例一样。穿过芯块(3)或保护壳(4)的孔(41)的尺寸和形状例如椭圆形，与芯块(3)或保护壳(4)的尺寸和形状相适应。该孔形成为将其边缘形成的角柔化(soften)，以降低底板上的摩擦。具有相应尺寸的该孔(41)当然也可以由多个更小的孔代替，其程度要与芯块或保护壳的尺寸和形状适应。例如，多个凹入的很小的蜂窝状的孔可以布置在芯块或保护壳的下表面上。
在一变化实施例中，至少出现在芯块(3)或保护壳(4)的下表面上的盲孔(41)通过凹槽(410)被延长，凹槽(410)一直延伸到该下表面的四周。这些凹槽(410)从而形成通道，通过这些通道来自周围组织的间质液体可以在芯块(3)或保护壳(4)的下表面之间滑动并起润滑作用以改善芯块(3)在底板(2)的上表面上的滑动。
孔(41)和进一步的凹槽(410)可以形成为，使芯块(3)下表面与底板(2)上表面之间的接触面积基本上等于芯块(3)上表面与顶板(1)下表面之间的接触面积。在该实施例中，施加在该假体上的约束因此将由芯块(3)的两个表面均等地吸收，从而通过优化芯块(3)相对于板(1，2)的位移来降低摩擦和提高芯块的使用寿命。
在芯块(3)的下表面被一保护壳(4)围绕的实施例中，芯块的下部比其上部要窄，使得一旦保护壳(4)安装在所述芯块的下部上，所述芯块就具有基本上一致的尺寸，如图2A至2E所示。在芯块的四周基本上在其厚度的中部，如图2B、2C和3A中所示的槽(33)与布置在保护壳(4)的边缘的内部如图2B、2C和3C所示的槽(43)互补以确保由芯块(3)和其保护壳(4)构成的组件之间的连接。当所述假体被安装时，芯块(3)就会被简单地装入保护壳(4)中。
芯块(3)在其上表面的至少一部分上具有特别如图2A至2D、3A至3B中所示的凸出部分(32)，该凸出部分(32)与顶板(1)的尤其如图4A、4C和4D中所示的凹入部分(12)互补。当装有所述假体的病人屈身时，该凹入部分(12)允许顶板(1)倾斜。芯块(3)或保护壳(4)的下表面和底板(2)的上表面可以为平面或基本上平坦的，从而不论在基本平行于底板(2)的轴线上平移时还是在绕着基本上垂直于底板(2)的轴旋转时，都允许芯块(3)相对于底板(2)存在间隙。在装有该假体的病人作运动时，顶板(1)的倾斜和芯块的间隙使芯块(3)朝向理想位置移动，以吸收施加在假体上的约束。顶板(1)和芯块(3)之间的运动以及芯块(3)相对于底板(2)的间隙允许病人运动，并选择性地消除假体的定位缺陷。该间隙同样具有防止由于施加在假体上的约束而导致的过早磨损的优点。所述钻在芯块(3)或保护壳(4)的下表面的盲孔(41)有助于改善芯块在底板上表面上的滑动，从而芯块可以找到理想位置以尽量快并尽量容易地吸收作用在假体上的约束。为了良好吸收约束，芯块(3)例如可以由聚乙烯，一种可以模拟自然椎间盘弹性的物理性能的可压缩材料制造。
根据本发明的一个实施例，由可压缩材料制成的芯块(3)的下表面可以由一金属保护壳(4)包围，以允许在金属底板(2)上更好的滑动以及减少可压缩材料的蠕变。芯块的滑动将通过在保护壳(4)的下表面上钻出的孔(41)例如一盲孔得以改善。
图1A、1C和5A至5E的实施例中，底板(2)包括两个在底板(2)的每一侧向侧上在底板(2)的两个边缘上相对布置的接触板(22)。每个接触板(22)构成底板(2)的凸起配合装置，并且每个都可以穿过芯块的凹入配合装置，其中，凹入配合装置由芯块(3)边缘上的槽(31)构成。在这些附图所示的实施例中，芯块(3)的每个槽(31)的尺寸都比底板(2)的每个凸块(22)的尺寸稍微大一些，从而不仅在沿着基本平行于底板(2)的轴线方向平移时还在绕着基本垂直于底板(2)的轴线旋转时限制芯块(3)相对于底板(2)的间隙。
在由可压缩材料制成的芯块(3)设置有在一金属底板上滑动的金属保护壳(4)的实施例中，保护壳可以呈一适应形状以使它不与底板的金属配合装置相接触。这样一种结果可以例如通过使保护壳的边缘与芯块的配合装置稍微偏置来实现。该变化实施例可以证明是必须的，这是因为在生物机体中优选地应避免两金属材料之间的冲击，这种冲击存在着将金属微粒散入周围组织并引起并发症的风险。
在一未示出的变化实施例中，芯块(3)的每个槽(31)的尺寸基本上与底板(2)的每个凸块(22)的尺寸相同，从而避免了芯块(3)相对于底板(2)之间无论是平移还是旋转中的任何间隙。在后面一种情况中，假体的唯一可允许的运动是顶板(1)相对于芯块(3)的运动。
在一未示出的变化实施例中，接触板(22)由在芯块(3)的边缘上朝假体内部呈弧形的凸块取代，从而防止芯块被抬起。在另外一个变化实施例中，凸块中的一个由在其上设有孔的接触板(或销)取代，在该孔中例如用销钉固定一个板(或搭扣)。由固定在接触板上的搭扣构成的该组件将具有与相对侧的凸块相同的形状并且实现相同的功能且具有简化安装所述假体的各个不同部件的附加优点。在一变化实施例中，两个凸块的每个都被用搭扣固定在其上的接触板代替。
在另一个未示出的变化实施例中，底板(2)的接触板(22)被半爪形接点(half dog point)替代。通过互补作用，所述芯块(3)将不再具有凹槽(31)，而是有两个位于其底面之下的洞(well)。底板(2)爪形接点和芯块(3)的洞的尺寸将根据期望的结果，通过选择在移动和旋转中芯块的微小间隙或任何间隙做适应调整。
在另一个未示出的实施例中，底板(2)的接触板(22)被一种壁所替代，所述壁彼此相对布置在底板的两条基本平行的边缘附近，但比接触板(22)更朝向假体的内部。芯块(3)包括与所述壁互补的凹槽。本实施例的芯块的每个凹槽的尺寸既可以稍微大于也可以基本等于底板的每个壁，从而允许或不允许在移动和旋转中有微量间隙。
在另一未示出的实施例中，凹入配合装置定位在底板(2)上，而凸起配合装置在芯块(3)上。
根据本发明的椎间盘假体尤其有助于校正脊柱前凸的缺陷。理想的是在假体的顶板(1)和底板(2)之间在前后方向上存在例如在0°到15°之间的锐角。作为病人的一种必需的功能，为了调整该角度，必须选择在代表芯块上表面的平均平面(average plane)与经过其下表面的平面之间具有适当角度的芯块(3)。这样一个角度同样可以通过制造这样的顶板实现，该顶板包括代表形成一角度的其下表面和上表面的平面装置(plane means)。另一个可能性涉及底板，其中所述代表其下表面和上表面的平面装置形成的一个角度。最终，只要采用与本发明相同类型的假体可以实现其他的可能性，这些可能性包括芯块的位置相对于假体的中心向后或向前稍微偏置，其中，所述假体包括然后形成一个角度的板。该芯块的稍微偏置的位置例如可以通过调整凸起和凹入配合装置的位置得以保持。
位于芯块边缘附近(即在芯块的外围附近)的凸起元件和凹入元件位于底板边缘附近(即在底板的外围附近的情况下)，脊柱前凸芯块(由于在前后方向上形成一锐角)可以通过伸入底板中的空腔或开口的突出物和板固连在一起。如果外科医生需要由病人而确定的脊柱前凸(lordosis)，他会选择一个相对底板(2)不具有任何间隙的芯块(3)。但是，如果他仅仅希望脊柱前凸保持在一定范围之内，他会选择一种在使所述板的至少一个轻微倾斜的位置附近相对于底板(2)在平移和旋转上都具有微量间隙的芯块。
在一个变化实施例中，根据本发明的椎间盘假体可以从其植入开始就牢固地锚固在脊柱里，以防止所述假体在由脊柱施加在就位的假体上的横向力的作用下发生移动，这是比脊柱前凸更重要的。在这种情况下，底板(2)包括一个或多个位于假体的后侧附近以接收锚固装置的开口。
因此，在变化实施例中，底板(2)的开口是圆形的并且锚固装置具有柱头的形状，其头部尺寸比开口更大以允许底板(2)被夹在锚固装置的头部和假体被固定在其上的椎骨之间。为了更加安全，开口可以制作成使锚固装置和底板之间形成一个小于或等于90°的角度。
将所述椎间盘假体植入病人并非易事。由底板、顶板和至少相对于底板可活动的芯块构成的假体的各个部件的活动性，导致这种难度增加。从而重要的是通过一种装置结合这些假体元件，使该装置可以被夹持并插入椎骨之间。根据本发明的这种装置由夹子(7)构成，其中该夹子的前表面(71)具有配合假体前边缘形状的形状。该夹子(7)在至少两个边缘上具有假体的夹持装置(72)。这些夹持装置(72)例如可以是两个安装在夹子侧边缘上的柔性叶片(72)，并且可以通过夹紧假体的顶板和底板的侧边缘来保持所述假体。夹子(7)的前表面(71)例如具有至少与假体高度基本相同的高度，从而可以与假体的每个板    的前边缘接触。
在本发明的一个实施例中，在夹子(7)的前表面(71)的中间部分具有槽(711)，从而可以接触芯块的前边缘，相对于板的前边缘稍微后置一些。当然也可以具有多个槽用于配合假体的形状。因此，具有槽(711)的夹子(7)的前表面(71)，当接触构成假体的三个部件时，可完美地与假体的前边缘的形状相配。从而，所述夹子有助于夹持所述假体并将其均匀地推向位于两椎骨之间的开口。该夹子(7)被设置成夹持所述假体并插入一加载器(6)(或者承载器，被称之为用于承载所述由夹子保持的假体的装置)。该加载器(6)具有一头部(62)，在该头部中具有用于接收所述夹持假体的夹子的空间；还具有沿着称之为导杆(5)的杆件滑动的本体(61)。夹子(7)的后表面可以在其中心设置一孔，该孔用于插入所述导杆(5)的端部(54)，从而所述导杆(5)可以保持和推动所述夹子(7)。该导杆(5)在其另一端配备有一推进器(52)，它通过使导杆(5)在加载器(6)的本体(61)中滑动将有助于将夹子和假体推出加载器(6)的头部(62)。一止动器安装在导杆(5)上的一个可调整的位置。例如，螺纹环(53)被旋拧在导杆上。该螺纹环滑入加载器(6)的本体(61)时，可作为导杆的止动器(53)。止动器(53)的位置是可调的，随椎骨的尺寸而变化，因此当导杆(5)的止动器(53)与加载器(6)的本体(61)接触时，导杆(5)的端部(54)已经将夹子推动直至这样一个位置，在该位置上由夹子的柔性叶片(72)夹持的假体已经被推出了加载器(6)的头部(62)并且相对脊柱的轴线对中。
在根据本发明的假体的一个实施例中，如前所述，顶板(1)和底板(2)在其表面上具有与椎骨相接触的齿或凹口(11和12)。这些凹口(11，21)定向成一旦将假体放入外科医生事先做好的两椎骨之间的开口时，则假体沿着与夹子退出的方向相反的方向移动。这些凹口(11，21)被定向成允许假体返回到其开口处，但是当外科医生将夹持着所述假体的夹子收回时所述假体不会出来。另一方面，位于夹子(7)至少两个边缘上的假体夹紧装置(72)的前端大于(厚于)它们的后端。夹子后端的宽度基本上等于(或稍微小于)加载器(6)的头部(62)中的空间的宽度。由于加载器(6)的头部(62)内的空间尺寸与假体和夹子(7)的尺寸基本相等，当假体和夹子(7)处于加载器(6)的头部(62)中时，夹子(7)的柔性叶片紧紧地将所述假体夹持住，其中，夹子的前端被压缩在所述假体与加载器(6)的头部(62)内的空间的内壁之间。当外科医生推动导杆的推进器(52)或对其施力时，假体将从加载器的头部(62)中出来并且由夹子(7)不那么紧紧地夹持住，这是因为柔性叶片的后端的夹紧程度不如前端。所述假体进而可以通过收回插入装置从夹子中释放，由于底板和顶板上的凹口，从而允许假体被保持在两椎骨之间的开口之内。
对于专业人士来说，在不背离本发明权利要求范围的前提下，本发明显然允许有许多其它特定形式的实施例。所以，当前实施例应当被认为是示意性的，可以在所附权利要求限定的范围之内进行修改，并且，本发明并不限定于上文中给出的各种细节。

Claims (31)

1.一种包括至少三个构件的椎间盘假体，该至少三个构件包括第一板(1)、第二板(2)和至少相对于所述第一和第二板(1，2)中的一个可以活动的芯块(3)，所述芯块(3)具有与所述第一板(1)的互补的弯曲表面的至少一部分相接触的弯曲表面和与第二板(2)的基本平坦表面的至少一部分相接触的基本平坦表面，位于第二板(2)的外围附近的凸起配合装置和芯块(3)的外围附近的凹入配合装置(22，31)或是位于第二板(2)的外围附近的凹入配合装置和芯块(3)的外围附近的凸起配合装置(22，31)允许没有过量摩擦地限制或防止芯块相对于第二板(2)沿基本平行于所述基本平坦表面的轴线平移，并且允许限制或阻止芯块(3)相对于第二板(2)绕着基本垂直于所述基本平坦表面的轴线旋转运动，其特征在于，芯块(3)包括至少一个盲孔(41)，用于促进芯块(3)相对于该盲孔所接触的第二板(2)的基本平坦表面滑动。
2.根据权利要求1所述的椎间盘假体，其特征在于，所述芯块的基本平坦的表面是芯块(3)的下表面，所述第二板(2)的基本平坦的表面是称之为底板的第二板(2)的上表面。
3.根据权利要求1所述的椎间盘假体，其特征在于，所述芯块(3)包括保护壳(4)，至少所述芯块的基本平坦表面被包围在保护壳(4)内，所述盲孔(41)位于保护壳的与第二板(2)的基本平坦的表面所接触的表面上。
4.根据权利要求3所述的椎间盘假体，其特征在于，芯块(3)的保护壳(4)并不覆盖芯块的凸起配合装置或凹入配合装置(31)，从而避免保护壳(4)与第二板(2)的凸起配合装置或凹入配合装置(22)相接触。
5.根据权利要求1所述的椎间盘假体，其特征在于，在芯块(3)的两侧，芯块(3)的基本平坦表面和第二板(2)的基本平坦表面之间的接触面积与芯块(3)的弯曲表面和第一板(1)的弯曲表面之间的接触面积基本上相等。
6.根据权利要求3所述的椎间盘假体，其特征在于，在芯块(3)的两侧，保护壳(4)的基本平坦表面和第二板(2)的基本平坦表面之间的接触面积与芯块(3)的弯曲表面和第一板(1)的弯曲表面之间的接触面积基本上相等。
7.根据权利要求3所述的椎间盘假体，其特征在于，由至少位于芯块(3)或芯块(3)的保护壳(4)的基本平坦表面上的盲孔(41)的边缘(411)所形成的角被柔化，以改善芯块(3)或保护壳(4)在第二板(2)的基本平坦表面上的滑动。
8.根据权利要求3所述的椎间盘假体，其特征在于，位于芯块(3)或芯块保护壳(4)的基本平坦表面上的盲孔(41)被延长，通过槽(410)形成通道直到该基本平坦表面的外围，其中，来自四周组织的间质液体能通过该通道提供润滑作用，以在假体被植入病人时改善芯块(3)在第二板(2)的基本平坦表面上的滑动。
9.根据权利要求8所述的椎间盘假体，其特征在于，由将盲孔(41)延长直到芯块(3)或芯块保护壳(4)的基本平坦表面的外围的所述槽(410)的边缘(411)形成的角被柔化，以改善芯块(3)或保护壳(4)在第二板(2)的基本平坦表面上的滑动。
10.根据权利要求1所述的椎间盘假体，其特征在于，所述芯块(3)由聚乙烯制成。
11.根据权利要求3所述的椎间盘假体，其特征在于，芯块(3)的保护壳(4)由金属制成。
12.根据权利要求1所述的椎间盘假体，其特征在于，第一板(1)和第二板(2)由金属制成。
13.根据权利要求1所述的椎间盘假体，其特征在于，所述凸起配合装置和凹入配合装置包括第二板(2)的凸起配合装置(22)，该凸起配合装置与芯块(3)的凹入配合装置(31)相配合。
14.根据权利要求1所述的椎间盘假体，其特征在于，所述芯块(3)相对于第一板(1)和/或第二板(2)是可活动的，并且第一板(1)和第二板(2)之间的可变角度取决于芯块(3)的位置，至少第一板(1)的任意方向上的倾斜导致芯块在第一和第二板(1，2)之间移动并向病人提供活动的自由，同时有助于消除假体的定位缺陷。
15.根据权利要求1所述的椎间盘假体，其特征在于，第一板的上表面与第二板下表面之间的角度通过代表芯块(3)的上表面和下表面的平面装置形成角度而实现。
16.根据权利要求1所述的椎间盘假体，其特征在于，第一板的上表面与第二板下表面之间的角度通过代表第一板(1)的上表面和下表面的平面装置形成一角度而实现。
17.根据权利要求1所述的椎间盘假体，其特征在于，第一板的上表面与第二板下表面之间的角度通过代表第二板(2)的上表面和下表面的平面装置形成一角度而实现。
18.根据权利要求1所述的椎间盘假体，其特征在于，第一板的上表面与第二板(2，1)下表面之间的角度通过利用凸起配合装置和凹入配合装置限制芯块(3)绕使至少第一板(1)倾斜的位置运动而实现。
19.根据权利要求1所述的椎间盘假体，其特征在于，所述的第一和第二板(1，2)能与不同厚度的芯块(3)组装在一起。
20.根据权利要求1所述的椎间盘假体，其特征在于，第一板(1)的表面的至少一部分是凹入的，并且和与其接触的芯块(3)的表面互补。
21.根据权利要求1所述的椎间盘假体，其特征在于，每个凸起配合装置的尺寸都小于每个凹入配合装置的尺寸，从而在芯块(3)和第二板(2)之间允许有微量间隙。
22.根据权利要求1所述的椎间盘假体，其特征在于，每个凸起配合装置的尺寸与每个凹入配合装置的尺寸基本上相同，从而防止在芯块(3)和第二板(2)之间出现任何间隙。
23.根据权利要求13所述的椎间盘假体，其特征在于，所述第二板(2)的凸起配合装置(22)是彼此相对着位于假体的两个边缘上的两个接触板，芯块(3)的凹入配合装置(31)是两个槽。
24.根据权利要求13所述的椎间盘假体，其特征在于，所述第二板(2)的凸起配合装置(22)是彼此相对着位于假体的两个边缘附近的两个壁，芯块(3)的凹入配合装置(31)是槽。
25.根据权利要求13所述的椎间盘假体，其特征在于，第二板(2)的凸起配合装置(22)是两个朝向假体内部弯曲并且彼此相对着位于假体的两个边缘上的凸块，而芯块(3)的凹入配合装置(31)是两个槽。
26.根据权利要求25所述的椎间盘假体，其特征在于，所述凸块的至少一个被设有孔的销取代，并且用穿过所述孔的销钉装置将一个板固定在所述销上。
27.根据权利要求1所述的椎间盘假体，其特征在于，第二板(2)的下表面和第一板(1)的上表面设置有位于假体的至少两个边缘附近的齿或凹口(21，11)，并且所述齿或凹口(21，11)被定向成防止假体的滑动并且通过假体连接到骨组织而作为锚固装置，其中，所述连接是由与椎骨接触的第一和第二板(1，2)表面的多孔的不排斥的覆层实现的。
28.根据权利要求1所述的椎间盘假体，其特征在于，至少所述第二板(2)包括一个或多个位于其前侧附近的开口，用于接收椎骨中假体的锚固装置。
29.根据权利要求28所述的椎间盘假体，其特征在于，第二板(2)的开口是圆形的，并且锚固装置具有柱头的形状。
30.根据权利要求28和29中任意一项所述的椎间盘假体，其特征在于，所述锚固装置的头部尺寸比第二板(2)的开口尺寸大，所述锚固装置被固定到椎骨中，所述第二板(2)被夹在所述锚固装置的头部和所述椎骨之间。
31.根据权利要求1所述的椎间盘假体，其特征在于，第一板上表面的至少一部分凸出，以适应椎骨的形状。
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AU2005211222A1 (en) 2005-08-18
US20050197706A1 (en) 2005-09-08
FR2865630B1 (fr) 2007-08-03
US8858635B2 (en) 2014-10-14
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CN1913846A (zh) 2007-02-14
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FR2865630A1 (fr) 2005-08-05

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