[go: up one dir, main page]

CN101090680A - 包括笼件、前板和两纵向杆的脊柱骨接合装置 - Google Patents

包括笼件、前板和两纵向杆的脊柱骨接合装置 Download PDF

Info

Publication number
CN101090680A
CN101090680A CNA2005800435572A CN200580043557A CN101090680A CN 101090680 A CN101090680 A CN 101090680A CN A2005800435572 A CNA2005800435572 A CN A2005800435572A CN 200580043557 A CN200580043557 A CN 200580043557A CN 101090680 A CN101090680 A CN 101090680A
Authority
CN
China
Prior art keywords
cage
cage spare
spare
vertebra
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.)
Pending
Application number
CNA2005800435572A
Other languages
English (en)
Inventor
W·C·鲍尔
P·杜邦
J－F·达摩尔
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Warsaw Orthopedic Inc
Original Assignee
Warsaw Orthopedic Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Warsaw Orthopedic Inc filed Critical Warsaw Orthopedic Inc
Publication of CN101090680A publication Critical patent/CN101090680A/zh
Pending legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. 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
    • 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 or setting implements
    • 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, e.g. 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7055—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant connected to sacrum, pelvis or skull
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/447—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7059—Cortical plates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8042—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being a cover over the screw head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891—Plurality of protrusions
    • A61F2002/30892—Plurality of protrusions parallel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2002/449—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Neurosurgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Prostheses (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Surgical Instruments (AREA)

Abstract

一种脊柱骨接合装置，所述装置包括：至少一个笼件(1、13)，笼件含有用于代替至少一个椎骨的骨移植物，其间设置有所述笼件(1、13)的所述椎骨(C2、C4、C1)与至少一个前板(17)融合在一起，所述前板(17)固定于其间设置有所述笼件(1、13)或至少一个所述笼件(1、13)的所述椎骨(C2、C4)，其特征在于，所述装置还包括：使所述前板(17)或至少一个所述前板(17)附连于面向其的笼件(1)的机构；在棘突两侧沿脊柱延伸的两个纵向杆(35、36)，使所述杆的末端附连于患者骨骼健康元件的机构，和将各杆连接于所述笼件(1、13)或至少一个所述笼件(1、13)的机构。

Description

包括笼件、前板和两纵向杆的脊柱骨接合装置
本发明涉及脊柱外科，具体地涉及颈椎外科。
多种脊柱骨接合装置是已知的，并且，当肿瘤或创伤如严重骨折导致一个或多个颈椎严重损伤而使它们非常不稳定时，这些装置可用于颈椎外科手术。
一些装置包括封闭在笼件内的骨移植物，以将两椎板与前板融合在一起。保留后突。但它们不可避免地不稳定。
通过在损伤上面或下面的区域增加后部附连板，在某种程度上可稍微稳定这些装置。但是，在多个椎骨的情况下，在损伤处存在大的杠杆臂。同样，损伤区域的后突不固定。
另一种根本解决方法包括完全切除受损椎骨及相关盘，并用其中设置有骨移植物的固体块代替它们，实现受损区域上方和下方所保留的椎骨之间的融合。然而，并未实现前侧和后侧稳定，在已知的实施方式中，必须增加独立于固体块的前板和/或后板。但是，即使在这种状态下，稳定性也不是最佳。
本发明的目的是提供给外科医生一种脊柱骨接合装置，以在切除一个或多个受损椎骨后实现最佳的脊柱前侧和后侧稳定性，尤其是脊柱颈椎部分。
为实现上述目的，本发明的目的是一种脊柱骨接合装置，它包括：至少一个笼件，笼件含有用于代替至少一个椎骨的骨移植物，其间设置有笼件的椎骨与至少一个前板融合在一起，前板固定于设置有所述笼件或至少一个所述笼件的所述椎骨，其特征在于，所述装置还包括：
使所述前板或至少一个所述前板附连于面向其的笼件的机构；
在棘突两侧沿脊柱延伸的两个纵向杆，使所述杆的末端附连于患者骨骼健康端的机构，以及使各杆连接于所述笼件或至少一个所述笼件的机构。
所述笼件可包括在其至少一个末端的环形元件，用于堆叠两笼件或用于将所述笼件锚定在椎板中。
所述将各杆连接于所述笼件的机构可由在笼件中形成的螺纹孔和穿过所述螺纹孔的螺钉构成，所述螺钉各头部包括接受和锁定所述杆之一的机构。
所述螺纹孔可在笼件的后侧边缘形成，控制所述螺钉的取向，使其对应于笼件所要代替的椎骨天然突起的取向。
所述螺钉可插入连接于所述笼件的插套中。
可将所述杆的一个末端形成为可固定于患者枕骨。
装置可包括多个笼件，每个笼件一块前板。
至少一个所述笼件可包括在其多个区域分布的所述杆的连接机构。
可能设有一个或多个环形元件的所述至少一个笼件的尺寸和形状适合替换颈部椎骨或多个连续颈部椎骨。
应理解，本发明基于以下组合：
前板，以其两端固定于经除去的受损椎骨区域上方和下方保留的椎骨；
包裹用于代替受损椎体及其相关盘的骨移植物的笼件或笼件叠加，所述笼件在至少一个水平固定于前板；和
在棘突两侧沿脊柱后部延伸的两纵向杆，每个杆在至少三点固定于脊柱，末端附连区域(顶部和底部)必须由健康骨骼元件构成，即两个完整的椎骨，或者一个完整椎骨作为底部附连区域而患者椎骨作为顶部区域；至少一个其它附连区域由上述笼件构成。
参考下面的附图，阅读以下给出的说明后将更好地理解本发明。
图1显示了植入患者颈椎上的本发明一个示例性装置的侧视图；
图2显示了上述示例性装置的前视图；
图3显示了沿图1和2中的线III-III的所述装置的截面图；
图4显示了本发明中使用的一个例子的笼件(图4a)及形成顶端和底端的环形元件(图4b)的立体图。
在图1-3详细描述和显示的实施例中，患者颅骨1的底部及其颈椎切除了椎骨C3、C5和C6及相关的盘。这样，椎骨C1、C2、C4和C7保持完整。
椎骨C3被大致平行六面体形状的笼件1(参见图4a)所代替，植入装置后，形成其中可包含骨植入物的中央区室2，从而实现相互面对的椎板C2和C4之间的融合。在所示实施方式中，笼件1在其两端具有环形元件3(参见图4a)，可插入和卡入笼件1内(在图1和2中只可见一个)以形成笼件1的顶面和底面。如图4a所示，笼件1包括中央区室2，中央区室2具有环形元件3可架在其上的边缘4。
这些环形元件3各自在笼件1和椎板C2或C4之间接触。为此，优选至少在其外周5周围包括具有凹纹6和凸纹7的蚀刻。凸纹7需嵌入相应椎板中，以提高笼件1与椎骨C2、C4之间的接合。
这些环形元件的另一个功能是在其长度及其端面角度方面限定笼件1的最终构型。如图所示，环形元件3的顶面和底面可不平行。在这种情况下，即使笼件1是如图所示的大致平行六面体形状，应通过形成非平行顶面和底面的环形元件3来构建形状，以在治疗区域尽可能接近地恢复脊柱的天然曲率。
因此，从单个基本模型开始，通过仅仅改变用于构建基本模型的环形元件的形状和尺寸即可实现不同长度的笼件1及其端面角度。
笼件1在其后侧部分10的边缘8、9上具有螺纹孔11、12，下面将描述这些孔的作用。
类似地，如图1和2所示，椎骨C5、C6及其相关的盘被类似于笼件1的笼件13代替，只是笼件13更长，代替两个椎体而不是一个。类似地，提供了类似于环形元件3的环形元件14、15。作为变化形式，笼件13可被两个嵌套在类似于元件3、14和15的环形元件周围的较短的笼件堆所代替。与笼件1的螺纹穿孔11、12相类似，笼件13的各个后缘16具有两个沿其高度分布的螺纹穿孔。
在图1-3中还可见前板17，它将笼件1固定于椎体C2和C4。为此，在所示实施例中，板17包括接近其两端的两个穿孔，两螺钉18、19穿过其中进入C2而两螺钉20、21穿过其中进入C4。两孔22、23形成在板17的中央部分，螺钉24、25穿过两孔进入笼件1对应的螺纹孔26、27以将板17固定于笼件1。优选地，板17包括用于垫圈29的外罩28，该垫圈29通过螺钉30固定于板17。垫圈29的外周对螺钉24、25的头部施加压力并防止它们从外壳移出。还存在类似的垫圈31、32以防止将板17固定在C2和C4上的螺钉18、19、20、21从其相应外壳中移出。
类似于板17的板也可使首先是代替C5和C6的笼件13、然后是C4和C7之间实现最佳接合或融合。为更清楚起见，图1和2中未显示。另一方面，显示了螺纹孔33、34，用螺钉将板固定在笼件13上。
使组件坚固并附连于患者骨骼的其它元件是在棘突两侧沿脊柱后侧延伸的两纵向杆35、36。
杆35、36必须至少在三个区域各自固定到脊柱上。至少两个附连区域必须是健康的骨骼元件，即两个健康椎骨或一个健康椎骨和患者枕骨37。两杆末端(脊柱最高和最低处)必须附连于这些健康元件。另一个附连区域是本发明装置所有笼件1、13的理想附连点。
图1显示了笼件，其中杆35、36在代替C3的笼件1的区域、代替C5和C6的笼件13的两个区域和椎骨C7上固定于枕骨37。杆35、36通过螺钉附连于枕骨37和C7，图1中未示出螺钉。将杆35、36固定在枕骨37上的螺钉穿过在各杆35、36的平面顶端42、43处为此目的而形成的孔38、39、40、41。将杆35、36固定于一个或多个健康椎骨的螺钉具有头部，杆35、36可插入和闭锁在头部中，如常规那样，或者具有连接件，杆35、36闭锁在其中而连接件本身固定于螺钉。
图1-3显示了将杆35、36固定于笼件1、13的优选方法，现在将参考将沿脊柱右侧延伸的杆35固定于代替C3的笼件1的装置进行描述。
如图3更好地显示，杆35插入螺钉45郁金香形头部44，在其中配合头部44的螺纹内壁而被螺纹栓塞46闭锁。在所示实施例中，头部44可相对于螺钉45的纵轴线多轴向取向。因此，螺钉45包括：头部44的底部与其配合的球形接触面47；和具有杆35可匹配在其中的面的中间环形部分48；以及在另一面的球形接触面49。配合头部内表面上形成的外周凹槽51，弹性环50将环形部分47保留在头部44中。头部44的多轴向取向性质使得外科医生能够非常自由地尽快放置装置、并使装置以最佳的可能方式与患者的解剖学结构和需要相匹配。
所示为大致平行六面体形状，应通过形成非平行顶面和底面的环形元件3来构建形状，以在治疗区域中尽可能接近地恢复脊柱天然曲率。
因此，从单个基本模型开始，通过仅仅改变形状和尺寸即可实现不同长度的笼件1及其端面角度。
在与设置头部44的末端相对的末端，螺钉45穿过形成在笼件1边缘9上的螺纹孔12。这样，首先通过螺纹栓塞46使杆45闭锁在螺钉45的头部44中，其次螺钉45插入笼件1中，实现了杆35与笼件1之间的刚性连接。
优选地，螺钉45在其整个长度上不直接接触外部介质，而是在孔12的入口处穿过旋在内侧和插入笼件1上的插套52。这样，在装置放置期间和放置后保护了可能与螺钉45头部相接触的任何器官(脊髓、神经根等)免于接触而造成损伤。作为变化形式，插套52可通过外螺纹旋入孔12的入口而不是简单地插入。
与上文刚刚描述的螺钉45-插套52组件相对称，笼件1在其另一边缘8包括螺钉53-插套54组件及其相关部件，类似地实现了沿脊柱左侧延伸的杆36与笼件1之间的连接。
类似地，代替C5和C6的笼件13包括类似于前述与杆35、36连接的组件的螺钉-插套组件。虽然图1-3中只显示了两个，但出于装置对称和刚性的原因，优选有四个，即每个被代替的椎骨有两个组件。
优选地，孔11和12可使螺钉45、43的取向大致对应于相应笼件1所要替换的椎骨天然突起取向。在所示实施例中，该取向与脊柱横轴线形成50度角。
显然，可容易地想象所述装置的变化形式。
具体地说，不同元件相互之间以及与患者骨骼之间的连接可不同于所述形式。
如果能够接受使用单片式非堆叠笼件的话，笼件1、13末端环形元件3、14和15的存在并不是必须的。在这种情况下，用于将笼件1、13附连于对应椎板的凸纹7可形成在笼件1、13的末端边缘，而所述边缘也具有恢复脊柱正常几何形状所需的取向。
如图所示，当本发明装置包括被一个或多个健康椎骨分离的多个笼件1、13时，使用前板17仅仅足以将一个笼件固定于它周围的健康椎骨。
为了放置本发明装置，外科医生首先在待替换的椎骨上(例如C3)进行前侧椎体切除术。然后，将笼件1及其环形元件3(如果有的话)植入适当位置。然后，放置前板17，首先将其固定于笼件1、然后再固定于健康椎骨C2、C4。接着，从切除后部骨元件(关节面和关节突)开始，进行后路手术。然后，将螺钉45固定在笼件1内并用插套52、54将它们闭锁。然后，将杆35、36的后侧附连装置设置到骨骼健康部件上。最后，通过使杆35、36与螺钉45和后侧附连装置相连接，将杆35、36设置在适当位置。
本发明装置尤其适用于颈椎区域。在该区域，宜使用需要前侧和后侧稳定的已知装置。但是，它也可用于脊柱其它区域。

Claims (9)

1.一种脊柱骨接合装置，所述装置包括：
至少一个笼件(1、13)，笼件含有用于代替至少一个椎骨的骨移植物，其间设置有所述笼件(1、13)的所述椎骨(C2、C4、C1)与至少一个前板(17)融合在一起，所述前板(17)将固定于其间设置有所述笼件(1、13)或至少一个所述笼件(1、13)的所述椎骨(C2、C4)，其特征在于，所述装置还包括：
使所述前板(17)或至少一个所述前板(17)附连于面向其的笼件(1)的机构(24、25)；
在棘突两侧沿脊柱延伸的两个纵向杆(35、36)，使所述杆的末端附连于患者骨骼健康元件的机构，和将各杆连接于所述笼件(1、13)或至少一个所述笼件(1、13)的机构。
2.如权利要求1所述的装置，其特征在于，所述笼件(1、13)包括在其至少一个末端的用于堆叠两笼件(1、13)或用于将所述笼件(1、13)锚定在椎板中的环形元件(3、4)。
3.如权利要求1或2所述的装置，其特征在于，所述将各杆(35、36)连接于所述笼件(1、13)的机构包括在笼件(1、13)中形成的螺纹孔(11、12)和穿入所述螺纹孔(11、12)的螺钉(45、53)，各个所述螺钉(45、53)的头部包括接受(44)和锁定(46)所述杆(35、36)之一的机构。
4.如权利要求3所述的装置，其特征在于，所述螺纹孔(11、12)在笼件(1、13)的后侧边缘(8、9)形成并控制所述螺钉(45、53)的取向，使其对应于笼件(1、13)所要代替的椎骨天然突起取向。
5.如权利要求3或4所述的装置，其特征在于，所述螺钉(45、53)可插入连接于所述笼件(1、13)的插套(52、54)中。
6.如权利要求1-5中的一项所述的装置，其特征在于，可将所述杆(35、36)的末端(42、43)之一的形状形成为可固定于患者枕骨(37)。
7.如权利要求1-6中的一项所述的装置，其特征在于，所述装置包括多个笼件(1-13)，每个笼件有一块前板(17)。
8.如权利要求1-7中的一项所述的装置，其特征在于，至少一个所述笼件(13)包括至分布在多个区域上的所述杆(35、36)的连接机构。
9.如权利要求1-8中的一项所述的装置，其特征在于，可能设有一个或多个环形元件(3、14、15)的所述至少一个笼件(1、13)的尺寸和形状适合于替换颈部椎骨或多个连续的颈部椎骨。
CNA2005800435572A 2004-12-16 2005-12-14 包括笼件、前板和两纵向杆的脊柱骨接合装置 Pending CN101090680A (zh)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR0413438 2004-12-16
FR0413438A FR2879434B1 (fr) 2004-12-16 2004-12-16 Dispositif d'osteosynthese rachidienne comportant une cage, une plaque anterieure et deux tiges longitudinales

Publications (1)

Publication Number Publication Date
CN101090680A true CN101090680A (zh) 2007-12-19

Family

ID=34951814

Family Applications (1)

Application Number Title Priority Date Filing Date
CNA2005800435572A Pending CN101090680A (zh) 2004-12-16 2005-12-14 包括笼件、前板和两纵向杆的脊柱骨接合装置

Country Status (9)

Country Link
EP (1) EP1827323B1 (zh)
JP (1) JP2008537890A (zh)
CN (1) CN101090680A (zh)
AT (1) ATE400238T1 (zh)
AU (1) AU2005316526A1 (zh)
CA (1) CA2591410A1 (zh)
DE (1) DE602005008103D1 (zh)
FR (1) FR2879434B1 (zh)
WO (1) WO2006065932A1 (zh)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103153218A (zh) * 2010-08-25 2013-06-12 捷迈脊柱公司 用于连接至骨结构的锚固件
CN110680573A (zh) * 2019-10-24 2020-01-14 北京爱康宜诚医疗器材有限公司 前后联合寰枢椎融合装置
CN110680575A (zh) * 2019-10-24 2020-01-14 北京爱康宜诚医疗器材有限公司 前后联合寰枢椎融合装置

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008106140A2 (en) 2007-02-26 2008-09-04 Abdou M Samy Spinal stabilization systems and methods of use
US9700425B1 (en) 2011-03-20 2017-07-11 Nuvasive, Inc. Vertebral body replacement and insertion methods
US10335207B2 (en) 2015-12-29 2019-07-02 Nuvasive, Inc. Spinous process plate fixation assembly

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5092893A (en) * 1990-09-04 1992-03-03 Smith Thomas E Human orthopedic vertebra implant
US6159211A (en) * 1998-10-22 2000-12-12 Depuy Acromed, Inc. Stackable cage system for corpectomy/vertebrectomy
GR1003979B (el) * 2000-08-21 2002-09-03 Θεολογος Θεολογου Προθεση αντικαταστασης ακεραιας σπονδυλικης μοναδος
FR2827156B1 (fr) * 2001-07-13 2003-11-14 Ldr Medical Dispositif de cage vertebrale avec fixation modulaire

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103153218A (zh) * 2010-08-25 2013-06-12 捷迈脊柱公司 用于连接至骨结构的锚固件
CN103153218B (zh) * 2010-08-25 2015-07-22 捷迈脊柱公司 用于连接至骨结构的锚固件
CN110680573A (zh) * 2019-10-24 2020-01-14 北京爱康宜诚医疗器材有限公司 前后联合寰枢椎融合装置
CN110680575A (zh) * 2019-10-24 2020-01-14 北京爱康宜诚医疗器材有限公司 前后联合寰枢椎融合装置

Also Published As

Publication number Publication date
WO2006065932A1 (en) 2006-06-22
EP1827323A1 (en) 2007-09-05
FR2879434B1 (fr) 2007-04-13
CA2591410A1 (en) 2006-06-22
JP2008537890A (ja) 2008-10-02
FR2879434A1 (fr) 2006-06-23
EP1827323B1 (en) 2008-07-09
AU2005316526A1 (en) 2006-06-22
DE602005008103D1 (de) 2008-08-21
ATE400238T1 (de) 2008-07-15

Similar Documents

Publication Publication Date Title
JP4448325B2 (ja) モジュラー式固定部を備える椎骨ケージ装置
US8353962B2 (en) Dual composition vertebral defect device
US8114138B2 (en) Vertebral template systems and methods of use
ES2462759T3 (es) Sistema para estabilización de tornillo pedicular guiado por alambre de vertebras de la columna
RU2605147C2 (ru) Система для задней фиксации позвоночника пластиной
US8425612B2 (en) Minimally invasive interbody device assembly
US9498560B2 (en) Interspinous spacer implant
JP4887360B2 (ja) 頚椎前方プレート
CN108498150A (zh) 脊柱植入系统和方法
US20090171394A1 (en) Devices And Methods For The Treatment Of Facet Joint Disease
CN101232851A (zh) 脊柱稳定的椎间假体装置及其植入方法
US8137402B2 (en) Vertebral defect device
JP2009509591A (ja) 前方複合インプラント
KR102560914B1 (ko) 회전가능한 플레이트 일체형 경추용 케이지 세트
US20130166028A1 (en) Composite layer intervertebral retrieving device
EP3015084B1 (en) Spinal fixation member
US8292923B1 (en) Systems and methods for treating spinal stenosis
CN101090680A (zh) 包括笼件、前板和两纵向杆的脊柱骨接合装置
CN107693169A (zh) 楔入式可调节人工椎体
US9855149B2 (en) Interbody fusion device
KR200305911Y1 (ko) 경추전방고정기기
CN106943186A (zh) 柔性棘突间固定器

Legal Events

Date Code Title Description
C06 Publication
PB01 Publication
C10 Entry into substantive examination
SE01 Entry into force of request for substantive examination
C02 Deemed withdrawal of patent application after publication (patent law 2001)
WD01 Invention patent application deemed withdrawn after publication

Open date: 20071219