CN1713864A - 椎间植入物 - Google Patents

椎间植入物 Download PDF

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Publication number
CN1713864A
CN1713864A CNA028300580A CN02830058A CN1713864A CN 1713864 A CN1713864 A CN 1713864A CN A028300580 A CNA028300580 A CN A028300580A CN 02830058 A CN02830058 A CN 02830058A CN 1713864 A CN1713864 A CN 1713864A
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CN
China
Prior art keywords
intervertebral implant
bar
groove
described intervertebral
cylindrical bar
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.)
Granted
Application number
CNA028300580A
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English (en)
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CN100396258C (zh
Inventor
R·弗里格
B·莱西曼
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AO Technology AG
Original Assignee
MARS MEDICAL TECHNOLOGY AG
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Publication of CN1713864A publication Critical patent/CN1713864A/zh
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Publication of CN100396258C publication Critical patent/CN100396258C/zh
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

本发明涉及椎间植入物(1),尤其人造椎间盘,它有一条中心线(2)以及A)一个板状上部(10),它适用于支靠在位于上方的椎骨体的底板上;B)一个板状下部(30),它适用于支靠在位于下方的椎骨体的盖板上,其中,C)在上部和下部(10;30)之间设一个板状中部(20);D)在上部(10)与中部(20)之间设一个有纵轴线(41)的第一圆柱杆(40);以及E)在下部(30)与中部(20)之间设一个有纵轴线(51)的第二圆柱杆(50)。

Description

椎间植入物
本发明涉及一种按权利要求1前序部分所述的椎间植入物以及一种按权利要求23所述的用椎间植入物替代损坏的天然椎间盘的方法。
在去除损坏的天然椎间盘或椎间盘损坏的髓核后,在两个相邻椎骨体的椎间空隙内置入植入物或假体。这样做的目的是重新造成尽可能自然的状态,也就是说,尤其在两个相邻的椎间体之间恢复原来的椎间盘高度并因而恢复原始的间距。此外,应能尽可能没有障碍地按其自然的方式实施相邻椎骨体彼此的相对运动。在这一方面重要的是,在向前/向后倾斜时,亦即椎骨体弯曲和伸展时,以及在椎骨体侧向屈折时,在自然的界限内保持运动的可能性。沿脊柱的天然韧带和肌肉基本上保持完整无损,所以它们继续稳定机械的椎间盘代用品的运动。
由DE-A-3529761 BTTNER已知一种按此类型的椎间盘假体。这种已知的椎间盘假体主要由两个对称的、有面对面定向的凹形滑动面和各一个在外部的表面的挡板以及一个定位在挡板之间、有与挡板上凹的滑动面互补设计的凸形滑动面的定距块组成,上述在外部的表面支靠在相邻椎骨体的底板或盖板上。按一种实施形式,滑动面设计为一个外圆柱形的部分表面,其中设在两个挡板上的滑动面设计为各与在定距块上的相邻滑动面互补,以及每两个互补的滑动面构成一个可绕旋转轴线旋转的关节的可互相移动的关节面。此关节包括一个上部和一个下部的各有一根旋转轴线的关节部分。这两根旋转轴线互相错开90°。这种已知的椎间盘假体的缺点是,
a)通过设计只有一个旋转中心的椎间盘内假体,不能考虑可以通过天然椎间盘传递的、尤其在天然椎间盘的情况下彼此独立的前-后和侧向弯曲时叠加的回转运动;
b)在两个可相互滑动的关节面上产生有害的摩擦力。此外,在关节部分运动时其结果是在这些表面产生磨损,亦即尤其磨坏和阻力。还存在粘滑(“stick-slip”)效应的危险;以及
c)机械的椎间盘代用品几乎不能避免所涉及的运动环节的继续退化。恢复原始的运动状况显著减轻痛苦以及使患者改善生活质量。然而当疼痛重新发生时必须对保养状况进行复查。在这种情况下通常完全拆降按传统结构方式的椎间盘假体以及加固运动环节。这种手术极大地加重患者的负担。
本发明提供补救措施。本发明的目的是创造一种椎间植入物,它包括一个关节,关节的轴提供摩擦力最小的支承。
本发明达到此目的通过一种有权利要求1特征的椎间植入物,以及通过一种包括权利要求23所述步骤用椎间植入物替代已损坏的天然椎间盘的方法。
采用本发明获得的优点主要是,由于按本发明的椎间植入物使得
-沿前-后方向和向侧面的回转运动是独立的;
-在总共四个线状接触部位上的运动摩擦面减小到最低程度;以及
-由于关节部分之间线接触取代滑动面,在关节内产生较小摩擦力,因而不妨碍椎骨体的相对运动,尤其是脊柱的侧向屈折和弯曲/伸展运动。
按本发明的椎间植入物另一种实施形式,设计两个互相对置的表面或两对互相对置的表面作为一根或多根圆柱杆的滑动面。这些滑动面可以设计为平的、圆柱形或锥形表面。
滑动面不同设计的优点在于,
-平的滑动面允许在相邻椎骨体彼此相对倾斜时以及相邻椎骨体彼此相对滑移运动时圆柱杆不受限制地运动;
-凹的或尤其圆柱形滑动面允许按照脊柱的运动环节考虑相邻椎骨体生理的倾斜运动;以及
-倾斜的滑动面允许与手术的同时校正脊柱前凸或脊柱后凸。
按本发明的椎间植入物另一种实施形式,在三个板状部分上设计为滑动面的表面设有周缘的边界作为杆的保险装置。由此可获得的优点是,借助所述的边界防止圆柱杆从三个板状部分之间的空隙掉落或挤出。
按本发明的椎间植入物再一种实施形式,至少在部分滑动面上设一些限制圆柱杆围绕中心线旋转的限制器/止挡。通过这一设计可带来下列优点:
-限制两根杆在一个确定的方向上的旋转,但有一个角向空隙;
-可将此方向调整为一根杆的前-后方向和另一根杆的中-侧方向;以及
-防止了两根杆互相平行定向,所以植入物的关节有两条彼此有间距的平行的旋转轴线,以及由此使两个与椎间植入物相邻的椎骨体只能实施弯曲/伸展运动和不能实施侧向屈曲,或反之。
按另一种实施形式,在一个或两个由四个滑动面构成的滑动面对上制一对槽,作为第一和/或第二杆的支座。优选地,每一对槽与要装在其中的圆柱杆是完全一致的。此实施形式的优点在于,通过槽的定位可以将相邻椎骨体的倾斜调整为只严格地沿预定的方向,如侧向倾斜以及弯曲和伸展。可能作用在脊椎关节上的剪力可由椎间植入物承接,因为与椎骨体相邻的板状部分不可能实施滑移运动。
按再一种实施形式,所述至少一对槽设计为与要装在其中的圆柱杆不一致,以及优选地有一个宽度,这一宽度允许杆绕中心线在槽内有限地转动。此实施形式的优点是限制了相邻椎骨体倾斜运动的可能性。与此同时可允许严格地沿侧向或严格地沿前-后方向滑移。
按另一种实施形式,至少部分槽有一个安置在周缘的限制装置/止挡,防止装在其中的杆轴向移动。优选地,槽与板状部分的侧面不连通,而是在槽的端部封闭。由此可以达到使圆柱杆不会平行于其纵轴线从槽中滑出。
优选地,用于第一杆的一对槽从相关的板状部分的前侧的侧面向背侧的侧面延伸,而用于第二杆的第二对槽在相关的板状部分侧向的侧面之间延伸。
通过第一杆纵轴线前-后定向以及第二杆纵轴线两侧定向,使一个关节有交叉的旋转轴线。这些槽优选地布置为,使得有前-后定向的纵轴线的杆在上,而有侧-侧方向的纵轴线的杆在下。但也可以相反,从而可以考虑显示脊柱的各个运动环节合乎自然的不同轴线位置的情况。
取代槽,杆的这种定向也可以通过设置限制器/止挡来实现。
按另一种实施形式,这包括可以弹性变形的装置,它们将板状上部和下部与处于它们之间的中部及两根杆互相维系在一起。这种可弹性变形的装置可以是弹簧或弹性体连接件。
按另一种实施形式,四个滑动面和两根杆是金属制的。
按本发明的椎间植入物再一种实施形式,四个滑动面是金属制的,而两根杆是陶瓷制的。
对于板状部分和圆柱杆下列尺寸是恰当的:
-圆柱杆的长度;大于与此杆接触的滑动面尺寸的二分之一;
-圆柱杆的半径:在0.3mm与5.0mm之间;
-滑动面的圆柱半径:在12mm与140mm之间;
-槽的宽度:在3mm与12mm之间;
-槽的深度:在0.2mm与4.8mm之间;以及
-圆柱杆绕椎间植入物中心线允许的旋转角范围:在1°与32°之间。
按另一种实施形式,可以在三个板状部分的前侧的侧面安置一些装置,借此可以将三个板状部分在前侧按规定的间距彼此相对固定。由此可获得的优点是,可将三个板状部分固定保持植入物高度地插入椎间空隙内的一个位置,在插入椎间空隙中后可绕关节运动并可被置于与相邻椎骨体的底板或盖板相支靠。
按另一种实施形式,此装置可以暂时锁止三个板状部分绕关节的运动。由此可获得的优点是,借助一种最小的侵入性手术,可以锁止整合在椎间空隙内的关节。这尤其在手术后出现疼痛的情况下是特别有利的,也就是说,在那里所涉及的脊柱环节发生进一步退化以及外科医生考虑将所涉及的椎骨并合。通过三个板状部分绕关节的运动能力这种后来的二次锁止,增强此椎间植入物并转化为一种关节固定术植入物(并合保持器)。
按再一种实施形式,装置包括一个嵌入件,它可分别插入上和下板状部分彼此对置的表面上的一个凹槽内。优选地,凹槽设计为燕尾状导向装置,它们在两个在外部的板状部分的前侧的侧面开口,所以嵌入件与燕尾状导向装置互补设计的端部可以从前侧插入燕尾状导向装置中。由此可获得的优点是,通过插入嵌入件可以锁止两个板状部分绕关节的可运动性。若将燕尾状导向装置设计为使它们朝椎间植入物的中心线渐缩,使嵌入件可以附加地楔入燕尾状导向装置,则可以增强锁止的刚性。
按再另一种实施形式,两个板状部分制有孔,用于安装骨固定装置,尤其骨螺钉,其中,孔的纵轴线相对于中心线处于倾斜的位置。优选地,两个板状部分之一的两个孔从前侧的侧面对合面贯通。若规定只是轴向固定椎间植入物,则纵轴线可以仅从侧向观察相对于中心线是倾斜的,或,若规定角向稳定地固定椎间植入物,则纵轴线从前侧观察可同样从两个板状部分的内表面朝对合面的表面是发散的。
按另一种实施形式,安装骨固定装置用的孔制有内螺纹,由此可做到将骨固定装置更加刚性地固定在两个板状部分中。优选地,这些孔设计为锥形,所以通过内螺纹与在骨固定装置头部的外螺纹之间的锥形螺纹连接,可以达到骨固定装置在两个板状部分的每一个上更牢固地固定。
对合面优选地设计为凸的并制有形式上的金字塔形隆凸的三维结构。通过对合面的这种设计,考虑了椎骨体端板的解剖学。
按本发明的方法主要用于通过椎间植入物替代受损的天然椎间盘并包括下列步骤:
A)借助为此所设的装置将椎间植入物的一个或多个关节锁定在关节规定的位置;
B)将椎间植入物插入要治疗的椎间空隙内;
C)拆卸和取走用于锁定在椎间植入物内的关节的装置。通过锁定关节可获得的优点是,具有在外部的对合面的板状可运动的部分可以更方便地置入要治疗的椎间空隙。
按本发明的方法的另一种应用,方法包括借助规定用于锁止关节的装置,事后锁定在已植入的椎间植入物上的关节。由此可获得的优点是,当出现患者的术后疼痛时,或当所涉及的运动环节进一步退化时,在椎间植入物上的关节可以通过手术后装上为此所设的装置锁定。这种事后的锁止可以通过最小侵入性,优选地腹腔镜检查术实施。因此,此椎间植入物承担保持器的任务,从而可以增强脊柱所涉及的运动环节。
下面借助多种实施例的局部示意图详细说明本发明和本发明进一步发展。
其中:
图1 按本发明的椎间植入物一种实施形式的分解图;
图2a-2c 以板状下部为例滑动面不同实施形式的三个透视图;
图3a 按本发明的椎间植入物一种实施形式的俯视图;
图3b 平行于在图3a中表示的按本发明的椎间植入物实施形式第二旋转轴线的剖面图;
图4 按本发明的椎间植入物另一种实施形式的分解图;
图5 平行于在图4中表示的按本发明的椎间植入物实施形式第二旋转轴线的剖面图;
图6 按本发明的椎间植入物另一种实施形式的分解图;
图7 按本发明的椎间植入物另一种实施形式的分解图;
图8a 按本发明的椎间植入物图7所示实施形式的俯视图;
图8b 平行于在图7和8a中表示的按本发明的椎间植入物实施形式第二旋转轴线的剖面图;
图9 按本发明的椎间植入物另一种实施形式的分解图;
图10a 按本发明的椎间植入物图9a所示实施形式的俯视图;
图10b 平行于在图9和10a中表示的按本发明的椎间植入物实施形式第二旋转轴线的剖面图;
图11 按本发明的椎间植入物另一种实施形式的透视图;以及
图12 按本发明的处于已植入状态的椎间植入物一种实施形式的透视图。
图1表示按本发明的椎间植入物1一种实施例,按中心线2上下排列,它包括一个上部10、一个下部30和一个在上部10与下部30之间的中部20,其中,上部10有一个前侧的侧面11、一个背侧的侧面12和两个侧向的侧面13,14以及横向于中心线2排列有一个上部对合面(Appositionsflche)15及一个下部表面16,下部30有一个前侧的侧面31、一个背侧的侧面32和两个侧向的侧面33;34以及横向于中心线2排列有一个下部对合面35及一个上部表面36,以及,中部20有一个前侧的侧面21、一个背侧的侧面22和两个侧向的侧面23;24以及与下部30相对有一个下表面25和与上部10相对有一个上表面26。这三个板状部分10;20;30正交于中心线2有卵形、椭圆形、圆形或多边形横截面。三个板状部分10;20;30成对地互相面对的表面16;26;25;35在这里设计为平的表面。在中部20的上表面26与上部10的下表面16之间插入第一圆柱杆40。此外,在中部2的下表面25与下部30的上表面36之间插入第二圆柱杆50。这两根圆柱杆40;50以这样的方式布置在表面16;26;25;36之间,即,使它们的纵轴线41;51垂直于中心线2。通过安装在表面16;26;25;36之间的圆柱杆40;50,保证上部10可相对于下部30绕圆柱杆40;50的纵轴线41;51旋转。
图2a至2c以板状下部30为例表示起滑动面作用的表面36不同的实施形式。其中,表面36在图2a中设计为垂直于中心线2的平面,以及在图2c中设计为凹的和圆柱形的。按图2b的板状下部30设计为楔形,其中,表面36设计为平的,但不垂直于中心线2。板状上部和中部10;20起滑动面作用的表面16;26;25可类似地设计。
在图3a和3b中表示的按本发明的椎间植入物实施形式,与图1所示实施形式的差别仅在于,三个板状部分10;20;30起滑动面作用的表面16;25;26;36如图2c中所表示的那样设计为凹的和圆柱形的。此外,表面16;25;26;36曲拱为,使第一圆柱杆40前-后延伸的纵轴线41与椎间植入物1的中心线2相交,而第二圆柱杆50的纵轴线51中-侧延伸并相对于椎间植入物1的纵轴线2有一距离。此外,表面16;25;26;36设有部分边界70,它们垂直于第二圆柱杆40;50的纵轴线41;51布置,以及防止杆40;50平行于其纵轴线41;51移动。
图4和5表示按本发明的椎间植入物的一种实施形式,它与图1所示实施形式的差别仅在于,在三个板状部分10;20;30上设计为滑动面的表面16;25;26;36设有周缘的边界70。
图6中表示的按本发明的椎间植入物1实施形式,与图4和5中所示实施形式的差别仅在于,在板状中部20的上表面26上安置了四个限制器/止挡80用于限制在上部10与中部20之间的第一圆柱杆40的运动,以及在板状下部30的上表面30上同样安置了四个限制器/止挡80用于限制第二圆柱杆50的运动。借助限制器/止挡80,限制了两根杆40;50的纵轴线41;51绕中心线2的转角。
图7和8表示按本发明的椎间植入物1实施例,其中,三个板状部分10;20;30成对的彼此配属的表面16;26;25;36制有横向于中心线2延伸的槽17;27;28;37。这些用于部分容纳圆柱杆40;50的槽17;27;28;37,有垂直于圆柱杆40;50纵轴线41;51的横截面,它们是椭圆的部分面。其中,用于容纳第一圆柱杆40的槽17;27布置为,使第一圆柱杆40的纵轴线41沿前-后方向延伸。容纳第二圆柱杆50的槽28;37布置为,使第二圆柱杆50的纵轴线51沿中-侧方向延伸。此外,这些槽17;27;28;37朝三个板状部分10;20;30的侧面11;12;21;22;23;24;33;34通过限制装置/止挡75封闭,所以圆柱杆40、50不可能平行于其纵轴线41、51从槽17;27;28;37移出。这两根圆柱杆40;50被槽17;27;28;37部分容纳,所以它们被轴向导向。槽17;27;28;37布置为,使第一圆柱杆40前-后延伸的纵轴线41沿直径方向并与中心线2相交,而使第二圆柱杆50中-侧延伸的纵轴线51与中心线2相隔一定距离。
图9和10表示按本发明的椎间植入物1一种实施形式,它与图7和8所示实施形式的区别仅在于槽17;27;28;37有一个与圆柱杆40;50纵轴线41;51垂直的横截面,它是部分圆形。两个圆柱杆40;50被槽17;27;28;37部分容纳,所以它们不仅沿轴向而且横向于其纵轴线41均通过这两个槽17;27;28;37导向,以及只能实施攻其纵轴线41;51的旋转运动。槽17;27;28;37布置为,使第一圆柱杆40前-后延伸的纵轴线41沿直径方向排列并与中心线2相交,而使第二圆柱杆50中-侧延伸的纵轴线51与中心线2相隔一个距离。
图11表示椎间植入物一种实施例,它与图1至10所示实施形式的区别在于,此椎间植入物1包括附加的装置90,由此可以可释放地锁止三个板状部分10;20;30彼此的相对运动。在图示的实施形式中,装置90包括一个可以从前侧那里横向于中心线2和平行于三个板状部分10;20;30侧向的侧面13;14;23;24;33;34插入的嵌入件91。嵌入件91的插入在两个凹槽92;93内进行,它们设计为燕尾状导向装置。嵌入件91从两个在外部的板状部分10;20的前侧的侧面插入设计为燕尾状导向装置的凹槽92;93内,以及各借助一个螺钉94固定在两个板状部分10;30上。此外,嵌入件91设计为端部与凹槽92;93互补,从而使两个在外面的板状部分10;30在插入嵌入件91时平行于中心线2彼此相对固定。此外,椎间植入物1还包括设计为弹簧61的可弹性变形的装置60,由此将三个板状部分10;20;30平行于中心线2维系在一起。由于可弹性变形的装置60可沿轴向弹性变形,所以并不妨碍三个板状部分10;20;30绕两根圆柱杆40;50起旋转轴作用的纵轴线41;51的可运动性。弹簧61设计为拉伸弹簧并固定在凸块62上,凸块62安置在两个在外部的板状部分10;30的侧面11;12;13;14;31;32;33;34上。
在图12中表示已植入两个彼此相邻的椎骨体之间的椎间植入物1一种实施形式。三个板状部分10;20;30定向为,使第一圆柱杆40的纵轴线41前-后延伸,以及使第二圆柱杆50的纵轴线51侧-侧延伸。

Claims (24)

1.椎间植入物(1),尤其人造椎间盘,有一条中心线(2)以及
A)一个板状上部(10),它适用于支靠在位于上方的椎骨体的底板上,上部(10)有一个前侧的侧面(11)、一个背侧的侧面(12)、两个侧向的侧面(13;14)、一个上部对合面(15)和一个下部表面(16);
B)一个板状下部(30),它适用于支靠在位于下方的椎骨体的盖板上,下部(20)有一个前侧的侧面(31)、一个背侧的侧面(32)、两个侧向的侧面(33;34)、一个下部对合面(35)和一个上部表面(36),
其特征为:
C)在上部和下部(10;30)之间设一个板状中部(20),中部(20)有一个前侧的侧面(21)、一个背侧的侧面(22)、两个侧向的侧面(23;24)、一个朝向下部(30)的下部表面(25)和一个朝向上部(10)的上部表面(26);
D)在上部(10)与中部(20)之间设一个有纵轴线(41)的第一圆柱杆(40);以及
E)在下部(30)与中部(20)之间设一个有纵轴线(51)的第二圆柱杆(50)。
2.按照权利要求1所述的椎间植入物(1),其特征为:第一部分(10)的下表面(16)和中部(20)的上表面(26)设计为与它们接触的第一圆柱杆(40)的滑动面。
3.按照权利要求2所述的椎间植入物(1),其特征为:用于第一圆柱杆(40)的两个滑动面(16;26)设计为平的、圆柱形或锥形面。
4.按照权利要求1至3之一所述的椎间植入物(1),其特征为:板状中部(20)的下表面(25)和板状下部(30)的上表面(36)设计为与它们接触的第二圆柱杆(50)的滑动面。
5.按照权利要求4所述的椎间植入物(1),其特征为:用于第二圆柱杆(50)的两个滑动面(25;36)设计为平的、圆柱形或锥形面。
6.按照权利要求2至5之一所述的椎间植入物(1),其特征为:一个或多个滑动面(16;26;25;36)至少部分设有周缘的边界(70)。
7.按照权利要求2至6之一所述的椎间植入物(1),其特征为:在一个或多个滑动面(16;26;25;36)上设一些用于圆柱杆(40;50)围绕中心线(2)旋转的限制器/止挡(80)。
8.按照权利要求2至6之一所述的椎间植入物(1),其特征为:在一个或两个由四个滑动面(16;26;25;26)构成的滑动面对(16;26、25;36)上制一对槽(17;27、28;37),作为第一和/或第二杆(40;50)的支座。
9.按照权利要求8所述的椎间植入物(1),其特征为:成对的槽(17;27、28;37)与要装在其中的圆柱杆(40;50)是完全一致的。
10.按照权利要求8或9所述的椎间植入物(1),其特征为:所述至少一对槽(17;27、28;37)设计为与要装在其中的圆柱杆(40、50)不一致,以及优选地有一个宽度,这一宽度允许杆(40;50)绕中心线(2)在槽(17;27;28;37)内有限地转动。
11.按照权利要求8至10之一所述的椎间植入物(1),其特征为:至少部分槽(17;27;28;37)有一个安置在周缘的限制装置/止挡(75),防止装在其中的杆(40;50)轴向移动。
12.按照权利要求8至11之一所述的椎间植入物(1),其特征为:用于第一杆(40)的一对槽(17;27)从相关的板状部分(10;20;30)的前侧的侧面(11;21;31)向背侧的侧面(12;22;32)延伸,以及用于第二杆(50)的第二对槽(28;37)在相关的板状部分(10;20;30)的侧向的侧面(13;14;23;24;33;34)之间延伸。
13.按照权利要求7所述的椎间植入物(1),其特征为:限制器/止挡(80)布置为使第一杆(40)的纵轴线(41)与相关的板状部分(10;20;30)的前侧和背侧的侧面(11;21;31;12;22;32)相交,以及使第二杆(50)的纵轴线(51)与相关的板状部分(10;20;30)的侧向的侧面(13;14;23;24;33;34)相交。
14.按照权利要求1至13之一所述的椎间植入物(1),其特征为:设可以弹性变形的装置(60),它们将板状上部和下部(10;30)与处于它们之间的板状中部(20)及两根杆(40;50)维系在一起。
15.按照权利要求14所述的椎间植入物(1),其特征为:可弹性变形的装置(60)是弹簧(61)或弹性体连接件。
16.按照权利要求2至15之一所述的椎间植入物(1),其特征为:四个滑动面(16;25,26;36)和两根杆(40;50)是金属制的。
17.按照权利要求2至15之一所述的椎间植入物(1),其特征为:四个滑动面(16;25;26;36)是金属制的,而两根杆(40;50)是陶瓷制的。
18.按照权利要求1至17之一所述的椎间植入物(1),其特征为:设装置(90),它们恰当地造成三个板状部分(10;20;30)彼此相对运动的暂时锁止。
19.按照权利要求18所述的椎间植入物(1),其特征为:装置(90)可以安装在三个板状部分(10;20;30)的两个前侧的侧面(11;21;31)上。
20.按照权利要求18或19所述的椎间植入物(1),其特征为:装置(90)包括一个嵌入件(91),它有一个下端(95)和一个上端(96),以及在两个在外部的板状部分(10;30)上各包括一个在表面(16;36)内的凹槽(92;93),它们在两个在外部的板状部分(10;30)的前侧的侧面(11;31)开口;以及,嵌入件(91)可将其端部(95;96)分别插入两个凹槽(92;93)之一中。
21.按照权利要求20所述的椎间植入物(1),其特征为:凹槽(42;43)是燕尾状导向装置,以及,嵌入件(41)上的端部(45;46)设计为与燕尾状导向装置互补。
22.按照权利要求21所述的椎间植入物(1),其特征为:燕尾状导向装置从两个在外部的板状部分(10;30)的前侧的侧面(11;31)朝两个在外部的板状部分(10;30)的背侧的侧面(12;32)渐缩。
23.用椎间植入物(1)替代损坏的天然椎间盘的方法,其特征在于下列步骤:
A)借助为此所设的装置(90)将椎间植入物(1)的关节(38;39)锁定在关节(38;39)的规定的位置;
B)将椎间植入物(1)插入要治疗的椎间空隙内;
C)拆卸和取走为锁定关节(38;39)而插入到椎间植入物(1)内的装置(90)。
24.按照权利要求23所述的方法,其特征为:方法附加地包括借助装置(90)将关节(38;39)事后锁定在已植入的椎间植入物(1)上。
CNB028300580A 2002-12-17 2002-12-17 椎间植入物 Expired - Fee Related CN100396258C (zh)

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BR0215957A (pt) 2005-09-13
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US20090024218A1 (en) 2009-01-22
JP4210653B2 (ja) 2009-01-21
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CN100396258C (zh) 2008-06-25
CA2510248A1 (en) 2004-07-01
US20060009850A1 (en) 2006-01-12
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CL2003002632A1 (es) 2005-02-04
DE50212250D1 (de) 2008-06-19
US7270682B2 (en) 2007-09-18
EP1572039B1 (de) 2008-05-07
AU2002347120B2 (en) 2006-10-26
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KR101004464B1 (ko) 2010-12-31
HUP0500737A2 (en) 2006-04-28

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