CN1388750A - 脊柱融合移植物 - Google Patents
脊柱融合移植物 Download PDFInfo
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- CN1388750A CN1388750A CN01802344A CN01802344A CN1388750A CN 1388750 A CN1388750 A CN 1388750A CN 01802344 A CN01802344 A CN 01802344A CN 01802344 A CN01802344 A CN 01802344A CN 1388750 A CN1388750 A CN 1388750A
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- repair implant
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- 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
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Abstract
一种改进的复修移植物10,在脊柱中相邻的椎骨之间形成一种刚性结构12。修复移植物10包括一个构架12,其具有顶壁20,底壁30,前端壁40,后端壁50,第一侧壁60和第二侧壁70。第一侧壁60有一弓形表面。顶壁20和底壁30包含一个或多个突起80与相邻的椎骨的表面啮合。顶壁20和底壁30还包含一个通孔100,用来接收填充物质300,如药物,人体组织等类似物。顶壁20和底壁30同时向两个方向倾斜。
Description
技术领域
本发明涉及一种将两个或多个椎骨连接在一起的修复移植物,特别是嵌入身体脊柱的修复移植物。
背景技术
本发明的权利要求得益于美国专利申请号为09/494,645,申请日为2000年1月31日的美国专利申请,该申请要求美国专利申请号为60/121,705,申请日为1999年2月25日,题目为“脊柱融合移植物”的美国专利的优先权。
本申请将1999年2月25日申请的美国专利,其美国申请号为60/121,705,题目为“脊柱融合移植物”作为参考文献。
人体脊柱由33块椎骨及其连接结构组成。众所周知,靠近头部的椎骨是荐前椎骨,并且可以分别独立活动。椎骨的主体是由前面及其后的韧带和纤维软骨盘就是所说的椎间盘相连接。这些盘位于相邻的椎骨体相对面之间。椎骨柱和椎间盘形成中心枢椎支撑头部和躯干。这些椎骨围成一脊髓从其中通过的通孔。
荐前椎骨通常由椎间盘,韧带和身体肌肉相互固定。这些椎骨相对于相邻的椎骨而活动,从而使头相对于身体转动,为脊柱的灵活移动提供了一个宽的范围。
在社会上化费最昂贵的健康问题之一涉及背部疼痛和脊柱病。这些问题影响不同年龄的人导致大量的患者承受病痛之苦。引起背部疼痛的几个因素如脊柱的先天畸形,脊柱的创伤损伤,脊柱的老化变质诸如此类。这些变化可能由于过度运动引起疼痛,或是运动环节的损伤引起脊椎管的收缩并压迫神经组织引起神经衰弱,神经麻痹或是两者交替可能引起神经根压缩或是脊柱狭窄。
神经传导紊乱也可能与椎间盘或椎骨自身有关。一种情况是椎间盘突出,少量的组织从盘的一侧延伸到通孔而压迫到脊髓。第二种普遍情况是在椎骨主体的后表面中的小骨刺又名骨赘的不断发展而接触到脊髓。
根据这些鉴定出的反常情况,需要外科手术来纠正这些问题。由于这些问题与骨赘的形成或是椎间盘突出有关,一种外科手术是椎间盘切除术,在这个手术中,涉及到的椎骨被暴露和椎间盘被移动,切除损坏的组织或是为骨赘的切除提供接近的机会。第二种手术称为脊柱融合术,需要把椎骨固定在一起防止移动保持椎间盘初始占有的空间。尽管这种手术可能会在脊柱中导致一些少数的椎骨失去灵活性,由于相对于大多数的椎骨来说,这些少数失去活动性的椎骨通常是能被接受的。
在脊柱融合术中伴随着切除术,修复移植物或脊柱移植物被插入椎间盘空间。这种修复移植物经常是从病人身体的另一部位转移而来的骨移植片,称为自身移植物。使用来自病人身体的骨有很大的好处,可以避免移植物的排斥反应,但也有一些缺点。为了获得移植物,进行第二次外科手术的部位总是有一定的风险,可能会引起感染或是给病人带来疼痛,骨质材料的切除使得移植物所在的部位变得脆弱。骨移植物可能没有最适合的形状和部位,导致移植物的滑动或是移植物的吸收,或是移植物与椎骨融合的失败。
移植物的移植源的其它的选择是从尸体转移的骨,称为异体移植物,或是从其它物种转移来的,称为异种移植物。在这些情况中的好处是不会可能由于第二次手术的部位引起感染和疼痛,但增加了移植物出现排斥的困难和传染性疾病传染的风险。
选择的方式有使用骨移植物或是使用由合成材料制成的人工移植物,这种材料在生物学上与人体和椎骨是一致的。有几种移植物的成分和几何形状已经被应用,应用的范围从简单的块状材料到精细形状的移植物,但并不都获得成功。
在发展可被接受的修复移植物方面进行了大量的尝试,该移植物能够被使用代替椎间盘或是至少在实现关节固定术完成后维持相邻椎骨间的椎间盘空间的稳定性,修复移植物有很多的形式,许多种合成修复移植物装置已经被提出,但实现的成功率很低,使外科手术错综复杂经常伤及到病人。
多数流行的修复移植物的设计采用圆筒状移植物形式,这种类型的修复移植物以Brantigan的4,878,915号专利和Ray的4,961,740号专利为代表。在圆柱状移植物中,圆柱体的外表部分是螺纹形有利于修复装置的插入。一些修复移植物被设计成插入椎间盘空间和椎骨的终板。这种类型的装置以Brantigan的4,834,757号专利和Brantigan的5,192,327号专利为代表。Brantigan和Ray的专利公开了一种修复移植物,其中该移植物的横截面贯穿于移植物的全长是恒定的,形成一种典型的圆形圆柱体。
其它修复移植物已经发展成为没有恒定的横截面。例如,Mckinna的4,714,469号专利说明一种半球形移植物,有延长的突起插入椎骨终板中。Bagby的4,934,848号专利中的移植物是球型的,位于两相邻椎骨的中枢间。
许多的移植物通常分成基本的两类,固体移植物和能促使骨再生长的移植物。固体移植物以美国专利申请号为4,878,915和4,349,921为代表。其它的专利讨论了关于骨能够通过移植物生长方面的问题。现已经发现这种设备能够加速骨神经的生长,更快速地稳定地完成关节固定术。这种移植物通常在插入椎间盘空间前用自身移植物填充。这种移植物通常包括椎通孔,用来连接移植物中的通孔,从而为组织在椎骨终板和骨骼或在移植物中的骨骼代替物之间的生长提供了一条途径。在为修复移植物准备的椎间盘空间时,椎骨的终板最好减少流血,有利于组织在移植物中的生长。
现在大多数可利用的修复移植物仍存在着一些困难。人们已经意识到中空移植物能使椎骨在骨或移植物中的骨的代替物中生长,对于实现融合术是最佳的技术。至少在没有一些辅助的固定设备例如杆、板之类的帮助下,多数的设备对于实现融合术是有困难的。而且,有些设备在结构上不能足够支撑沉重的负重,这种负重最频繁地作用在融合椎骨上,主要是在较低的腰脊柱上。
在关节固定术中,需要提供一种修复移植物,这种移植物能够优化骨骼向内生长能力并具有足够的强度以支撑椎骨一直到关节固定。还需要这样一种移植物能够在器械分段上维持或恢复正常的脊椎解剖。还需要一种移植物能够在被插入椎骨中时减少滑动并减少神经萎缩的发生。
发明内容
本发明涉及一种改进的移植物,尤其是涉及一种改进的修复移植物,其使用便于两个或多个椎骨的融合。
根据本发明的基本特征,提供了一种修复移植物在生物学上与人体相容的材料。修复移植物的形状和尺寸根据其插入两块椎骨间的情况而确定。在一个具体的实施例中,修复移植物被放入椎间盘空间,这个空间原先是由一个椎间盘所占据的。在椎间盘部分或全部被切除前要在两块椎骨间插入修复移植物。在一个具体的实施例中,构架的形状和尺寸的选择在解剖学上有正确的形状。在另一个具体的实施例中,修复移植物被制作成可以增大与椎骨的连接面积和/或逼真的仿效原先由椎间盘占据的区域。在另一个实施例中,修复移植物设计成在手术中很容易地被插入,使手术的难度降低到最小限度。在另一个实施例中,移植物在几何学上能够确保支撑适合的负重和所希望支撑的负重,使在手术中或椎骨融合过程中的修复移植物和相关的椎骨脱臼的可能性降低到最小限度。
根据本发明的另一个的特征,提供一种修复移植物其包括一个骨架构架,该构架有一顶壁,一底壁,一前端壁,一后端壁,第一侧壁和第二侧壁。在一个实施例中,构架是由惰性的或在生物学上与椎骨相一致的材料构成。构架的材料由以下材料组成但不局限于以下材料,如骨,不锈钢,钛,铬合金,钴,聚碳酸酯,聚丙烯,聚议席,有机玻璃,填充有玻璃和/或由碳纤维的polysolfone型材料和各种类型的碳和纤维加固聚合物组成的。在另一个实施例中,构架可以在盘组织上维持10到40磅的拉伸负重,更好的能维持15到35磅的拉伸负重。拉伸负重有利于维持构架在两椎骨中的位置并且加速骨骼在椎骨间的生长。在另一个实施例中,构架是由与椎骨的弹性十分接近的材料组成。在另一个实施例中,构架上附着射线透明的材料和/或由射线透明材料所组成,这种材料在受到X射线照射时加强了移植物的可见性。
根据本发明的另一个特征,移植物构架的第一侧壁和第二侧壁沿着构架的纵向轴充分的延伸并且其中形成的两个侧壁增强了构架在椎间盘空间的稳定性。在一个实施例中,第一侧壁和/或第二侧壁至少部分是弓形。在另一个实施例中第一侧壁和第二侧壁有不同平面的结构。在一个具体的实施例中,第一侧壁包括一个弓形表面,第二侧壁有一个十分平坦的表面。在一个具体的实施例中,第一侧壁有一很标准的弓形表面。在另一个具体的实施例中,弓形表面的半径曲率大约是2度到30度。构架的第一侧壁表面的外形是弓形的,构架被放在椎间盘空间,其中十分平或平坦的第二侧面被放在靠近临近脊髓的位置,第一侧面被放在临近椎间盘空间外围边的位置,修复移植物的构架具有弓形或曲线的侧壁,这种结构更加与椎间盘空间的表面相符合,从而更加提高了两块椎骨的融合的成功率。构架的不同侧面的外形还具有可视的功能,这确保了构架在两块椎骨间正确的方向。
根据本发明的另一个特征,修复移植物的构架包括一顶壁和/或底壁,其中至少具有一个刚性表面使其适合在椎间盘空间中与椎骨的下表面相啮合,突起的设计是保证安全或与椎骨表面相咬合。在一个实施例中,顶壁包括多个突起表面。在另一个实施例中,底壁包括多个突起表面。在顶壁和/或底壁上的突起表面有几种的外形。在一个具体的实施例中,突起具有菱形的表面,而且其作用近似于牙齿结构。在另一个实施例中,突起是一种遍布顶壁和/或底壁横向和/或纵向表面的统一结构。在另一个实施例中,突起位于顶壁或/或底壁上并与底壁或顶壁外围边分开。在另一个实施例中,顶壁或底壁有近似的突起外形和近似的突起数量,然而,顶壁或底壁有不同数量或不同外形的突起也是可以的。在另一个实施例中,在两椎骨间构架中的顶壁或底壁的突起与构架相啮合并且为骨骼向内生长提供了渠道,有利于加速椎骨的融合。
根据本发明的另一个实施例的特征,修复移植物的构架在一个或多个构架的墙壁内包括一个或多个通孔。在一个实施例中,通孔被设计用来接收一些物质,该物质有利于椎骨的融合,有利于构架和椎骨的定位和/或确保构架在椎间盘空间适当的位置。在一个具体的实施例中,一个或多个通孔被设计用来接收一些填充物质,这些物质有利于在两椎骨间的移植物的形成。这样的填充物质可以包括以下物质但不仅限与以下物质,如药物,人体组织,动物组织,合成组织,人体细胞,动物细胞,合成细胞等等。在另一个具体的实施例中,构架由多个通孔组成,这些通孔可以使血液供给构架的侧面到在构架间的椎骨的生长。在另一个实施例中,构架中的一个或多个通孔接收填充物质,这些填充物质由一种或多种可选择的成分组成,这些物质呈放射性地,纵向地和/或垂直地从构架中的通孔中长出,长入到与连接相邻椎骨的骨组织中。在另一个具体的实施例中,一个或多个通孔接收骨物质或合成物质,存在或不存在使骨活动的物质,例如羟磷石灰骨或生殖器蛋白质,骨生长因子或软骨活动因子。在另一个实施例中,构架中的顶或底壁具有一个通孔,通孔与构架内部的腔相连。在另一个实施例中,顶壁或底壁上至少有一个通孔,这个通孔具有十分相同的形状和尺寸。根据另一个实施例,第一侧壁,第二侧壁,前端壁和/或后端壁至少包括一个通孔可以适合接收一个器械用来导入和/或插入脊柱的两椎骨间的构架中,可以从前面,后面,侧面或斜侧面靠近脊柱的地方接近构架。该通孔允许外科医生选择哪一种接近位置最适合在椎间盘空间插入修复移植物。在一个具体的实施例中,器械通孔包括一定位装置,如,但不局限于,一螺纹,在通孔中确保该装置位于通孔内。
根据本发明的另一的特征,构架中至少有一个或多个边成为圆角而不再是锐角。圆角形的边对病人来说可以减少或完全消除由脊髓引发的神经疼痛,神经破坏或神经麻痹。圆角形的边可避免或减小椎骨出口的脊髓神经的神经压力。一个或多个圆角形的边还可以方便地在椎间盘空间插入构架。在一个具体的实施例中,构架的侧面边是圆角形的。在另一个具体的实施例中,构架的所有边都是圆角形的。
根据本发明的另一特征,顶壁和/或底壁至少部分是沿构架的纵轴倾斜的。在一个实施例中,顶壁和/或底壁是从后端壁到前端壁均匀地倾斜。在一个具体实施例中,后端壁高于前端壁。在另一个具体的实施例中,顶壁或底壁的倾斜角度约从0.5到15度,较好的角度约从1度到10度,最佳的角度约从3度到8度。构架的顶或底壁的倾斜有利于构架被灵活地被插入椎骨柱中,和/或提供一个更适合在椎间盘空间的构架,因为倾斜可以更好的与脊柱中的两椎骨间的空间解剖形状相匹配。根据另一个实施例,倾斜的顶壁和/或底壁的构架能适和脊柱中两椎骨间构架的定位,并且在构架的顶壁和/或底壁上的突起更适合与椎骨的骨表面连接,确保在椎骨完全融合前构架在两椎骨间的定位。
根据本发明的另一特征,在构架的第一和第二侧壁间,顶壁和/或底壁至少有部分是倾斜的。在一个实施例中,顶壁和/或底壁从第一到第二侧壁是均匀地倾斜。在一个具体的实施例中,第二侧壁是高于第一侧壁。在另一个具体的实施例中,顶壁和/或底壁的倾斜角度约是从0.5到15度,较好的倾斜角度约从1度到10度,最佳的倾斜角度约从3度到8度。构架的顶壁和/或底壁的倾斜有利于构架被灵活地插入椎骨柱中,或提供一个更适合在椎间盘空间的构架,因为倾斜可以更好的与脊柱中的两椎骨间的空间解剖形状相匹配。
根据本发明的另一特征,一对构架用来支撑和/或融合在脊柱中的两块椎骨。在一个实施例中,构架被并排的定位在相邻的两椎骨间形成一个固定的横向支撑。
本发明的一个目的是提供一种在两椎骨间插入的改进的修复移植物。
本发明的另一个目的是提供一种在两椎骨间能更好的仿真修复移植物之间的空间。
本发明的再一个目的是提供一种修复移植物,其包括一个或多个突起帮助修复移植物在椎骨间的定位。
本发明的再一个目的是提供一种修复移植物可以并排地使用在相邻的椎骨间形成一个固定的横向支撑。
本发明的再一个目的是提供一种修复移植物,其提供了改进的脊柱支撑的稳定性并且提供一种可以在相邻的两椎骨间的稳定的方法和有利于确保修复移植物在两椎骨间的安全的形状。
本发明的再一个目的是提供一种装置可以帮助在两椎骨间固定修复移植物。
本发明的再一个目的是提供一种修复移植物,其具有一个或多个通孔用来接收填充物质以利于两块相邻位置椎骨的融合。
本发明的再一个目的是提供一种修复移植物能容易地并且有效地定位在两块椎骨间,可以减少修复移植物在两椎骨间定位的失败率。
本发明的再一个目的是提供一种修复移植物包括一个或多个倾斜面有利于在相邻位置的两椎骨间插入修复移植物,可以更好的将修复移植物的形状与相邻位置的椎骨间的空间形状相匹配。
本发明的再一个目的是提供一种修复移植物,其由一些表面组成的,这些表面可以减少修复移植物挤压脊髓和与修复移植物相邻近的其它部位。
本发明的再一个目的是提供一种修复移植物在生物学上相兼容的材料构成。
本发明的再一个目的是提供一种修复移植物可以由一种射线可透的材料制成和/或用该材料覆盖。
本发明的再一个目的是提供一种修复移植物由十分接近椎骨弹性的材料构成。
为了便于理解本发明的上述发明目的和其它的发明目的,现将结合下述优选实施例和附图做详细的说明。
附图说明
结合附图详细描述本发明的实施例,其中:
图1是本发明的修复移植物的平面顶视图;
图2是本发明的修复移植物的立体图;
图3是本发明的修复移植物的侧视图;
图3A是图3中修复移植物顶壁交错突起结构的放大视图;
图4本发明的修复移植物的另一个实施例的立体图,用来说明双重倾斜的顶壁和底壁的修复移植物。
图4A是图4中修复移植物的后端视图;
图5是脊柱的侧视图,其中包括本发明的在两块相邻位置的椎骨间定位的修复移植物。
图6是图5中的一部分的后视图,表示定位于两块脊椎椎骨间的两块相邻位置的修复移植物。
具体实施方式
参照附图,该附图仅用于说明本发明的优选实施例并不用于限制该实施例,图1-图3是一种修复装置或修复移植物10,被设计用来插入到椎间盘空间和脊柱中的两块椎骨之间。如修复移植物10所示一个类似构架结构的12具有一个顶壁20,一个底壁30,一个前端壁40,一个后端壁50,第一侧壁60和一个后侧壁70。如最佳显示在图1和图2中,顶壁20由多个突起结构80组成,这些突起沿修复移植物10的纵向长度排列。如图3所示,突起结构80被包含在底壁30上。突起结构能被切入顶壁和底壁和/或由成型加工而成。突起结构被设计成一种与椎骨下表面咬合和/或容易相连的刚性接触,这样确保修复移植物在两椎骨间的安全并且在修复移植物被正确的定位在两椎骨间后,减少修复移植物的移动。
参照图1和图2,突起结构80与顶壁20的外围边部分22中间有间隔。底壁上也存在同样间隔的突起。顶壁20包括一通孔100。很多不同的突起外形可以使用在构架10的顶壁或底壁上。如图1和图3A所示是两种最佳外形,在图1中,突起结构是凹槽型突起,这些突起的方向是沿着构架12的横轴方向。突起结构有两个侧面并且长度相似。在一种方案中,突起结构从突起底部到突起顶部的高度约是0.01到0.05英尺,两个突起顶部间的距离约是0.01到0.12英尺。值得一提的是,为了能够使用在特殊的应用中,这些突起结构的尺寸能被修改。
现参照图3A,图中所示一种可选择外形的突起结构。突起结构80通常是菱形结构,其中每一个突起结构有四个壁,菱形突起结构的壁82通常具有相同尺寸和形状。在一种方案中,突起结构从突起底部到突起顶部的高度约是0.01到0.05英尺,两个突起顶部间的距离约是0.01到0.12英尺。值得一提的是,为了能够使用在特殊的应用中,这些突起结构的尺寸能被修改。
突起结构可以在顶壁或底壁上确定方向,有利于两个或多个修复移植物的堆集。
参照图1和图4,构架12的顶壁或底壁包括通孔100,120。如图所示通孔100,120是半椭圆形,但是也能使用其它的通孔形状。通孔大小的选择是以填充物质300能被插入通孔中而确定的。在一种理想的方案中,通孔100,120的尺寸放到最大以增加能被插入构架中的填充物的体积,并且不会对构架结构产生负面影响。如图1和图4所示,通孔100和120有相似的形状和大小,但是其它形状和大小的通孔也可以使用。图中所示的通孔有一外围边空间并且此空间到顶壁或底壁的外围边的距离通常是相同的距离。在一种理想的方案中,从顶壁或底壁的外围边到通孔的外围边的间距约是0.05到0.25英尺,其它的材料和尺寸构架的间距也能使用。
现参照图1,图2和图4,构架12包括一腔130。所示的腔130与在构架12的顶壁和底壁的通孔100,120相连。腔的设计可增加插入构架中的填充物质的数量。填充物质300包括下述物质,但不局限于该物质,如药物,组织,细胞等等。在一种理想的方案中,填充物质的选择有利于骨在两椎骨间及其间插入修复移植物的椎骨间的生长。
现参照图2,第一侧壁60沿壁的纵向长度具有弓形或曲线形的形状。第一侧壁弓形的选择在解剖学上与椎间盘空间更加匹配。如图所示第二侧壁70具有一十分平直或平坦的表面。当修复移植物10被定位在椎间盘空间,第二侧壁70被定位在与脊髓很接近的位置并且第一侧壁60被定位在接近椎骨外缘的位置。曲线形的第一侧壁和大体平直或平坦的第二侧壁的设计使之与椎间盘空间更加相匹配并且增加了与椎骨的接触面积,减少了滑动,增加了两块椎骨融合的成功率。值得一提的是,第一侧面60的弓形形状的调节依靠于其中插入修复移植物的椎骨。更值得一提的是,第二侧壁70的形状也可以包括不平坦的表面,这样更利于修复移植物的表面更大限度的与其下部的椎骨表面接触。在一个理想的实施例中,平坦的第二侧壁的长度约是0.5到1.2英尺,高度约是0.2到0.8英尺。在另一个理想的实施例中,第一侧壁的曲率半径约是0.3到0.9英尺,高度约是0.1到0.75英尺。值得一提的是,侧壁的大小和外形可以呈现出的尺寸和外形是依靠修复移植物使用的情况而定。
参照图2,第一侧壁60和第二侧壁70包括通孔140与内部的腔130相连。在顶壁和底壁上的通孔100和120,通孔140被设计成接收填充物质300,使血液在腔130内的填充物质和椎骨周围的区域之间流通。如图所示通孔140是菱形,但是其它的形状也可以使用。如图所示每一个侧壁包括两个通孔140,但是侧壁也可以包括更多或更少的通孔。在一个理想的实施例中,在没有影响构架结构的完整性的情况下,椭圆或菱形的通孔都可以使用在侧壁上从而最大程度的增加了通孔的尺寸。
参照图2,侧壁包括器械通孔150被设计用来接收器械,能够将修复移植器械以几个不同的方向插入椎间盘空间。在一个理想的实施例中,修复移植物包括多个通孔150能够将修复移植物从前面,后面,侧面或/和斜侧面方向插入到椎间盘空间。在另一个理想的实施例中,器械通孔150是一螺纹通孔能够安装螺纹装置。螺纹通孔使得一装置容易妥善地被放置到修复移植物10中和/或被从修复移植物10中移出。器械通孔150也能用于确保修复移植物颈部螺丝钉的安全使用,这样有利于修复移植物附着一棍或平板的加固系统。
现参阅图2和图4,前端壁和后端壁40,50包括一器械通孔160。器械通孔160的外形和功能与构架12的第一侧壁和第二侧壁上的器械通孔150的外形和功能相同。
现参阅图2,构架壁的外围边是圆形或环形的。圆型边200的设计减小或消除了在构架上尖锐边,减小或消除了对神经的挤压,并且有利于定位构架在椎间盘空间的定位。
现参阅图3,构架的顶壁或底壁是倾斜的。图中所示顶壁20和底壁30从后端壁50向前端壁40方向向后倾斜。倾斜的角度通常是均匀的贯穿于整个移植物的长度。修复移植物的顶壁或底壁两面的倾斜角度是相同的。由于顶壁或底壁的倾斜表面后端壁50的高度高于前端壁40。在一个理想的实施例中,后端壁的高度约是0.2到0.8英尺,前端壁的高度约是0.1到0.75英尺,从后端壁到前端壁的顶壁或底壁的倾斜角度约是0.5到20度。
现参阅图3,图4和图4A,构架12的顶壁和底壁从第二侧壁向第一侧壁倾斜。在一个理想的实施例中,从第二侧壁到第一侧壁的顶壁和底壁的倾斜角度是很均匀的。由于顶壁和底壁的倾斜,第二侧壁的高度高于第一侧壁。在另一个理想的实施例中,从后端壁到前端壁的顶壁和底壁的倾斜角度约是0.5到20度。
现参照图5和图6,如图所示的是人体椎骨柱210的较低部位图。图5所示的是脊柱的5个较低部位的椎骨。本发明的修复移植物10将椎骨220和椎骨230分隔开并且支撑。图中所示的椎间盘250将其它的椎骨分开并且支撑,相连的两椎骨间保持一定空间260。在修复移植物10插入其椎间盘250之前,损坏部分已经从椎骨220和230中切除。如图6所示,两块修复移植物10并排地定位在椎骨220和230之间。
总之,发明的一个实施例,修复移植物是一个固体结构的构架具有一个或多个腔。移植物在手术中被插入椎骨柱中,为椎骨柱中的椎骨提供一种负重的支撑。移植物是一种向后倾斜的形状,所以最靠近脊柱的中间部位高于后边部位。移植物在构架中有一个或多个通孔接收不对人体排斥的填充物质。这些填充物质包括下列物质,但不局限于以下物质,自身移植骨,捐赠的人体骨,其它动物材料和其它自然和/或人工材料。构架从前面向后面倾斜。构架有圆型的边可以减少脊椎的挤压。构架的顶壁和底壁包括突起或凹入顶壁或底壁的槽,有利于固定两块椎骨间的构架。突起可以有不同的外形,交叉形或牙齿形的设计构成了菱形或锥形的外形。构架有一个或多个弓形或曲线形的侧面构成了椭圆形的构架或双半球板的外形。
在最普遍的应用中,可以利用两个修复移植物插入椎间盘空间,脊柱的两侧的各放一个。修复装置将代替在手术中部分或全部切除的损坏或受伤的盘。在手术过程中,移植物可以插入并固定在一个位置,从而可以避免侵入到脊髓区域同时可以避免延伸到椎骨柱的外侧。修复移植物的最佳放置是本发明的移植物的应用。
本发明的移植物对于现有技术的优点和改进是:
移植物的拐角是圆角形。
移植物的顶壁从一侧壁向另一侧壁倾斜。
移植物的底壁从一侧壁向另一侧壁倾斜。
移植物的顶壁从一端壁向另一端壁倾斜。
移植物的底壁从一端壁向另一端壁倾斜。
移植物包括较大的和/或更多的通孔有利于填充具有骨和骨骼促长剂的移植物。
移植物的顶壁和/或底壁的表面包括具有菱形表面的突起,这样可以更好的固定骨骼。
移植物的壁包括一个或多个螺丝通孔,确保移植物在手术中从前面,后面,侧面和斜侧面的部位被插入。
移植物被设计用来接收穿钉螺丝和夹板,以抑制移植物在椎间盘空间移动。
移植物可以由各种材料组成,例如碳化纤维沫或聚合物,其它的聚合物,各种金属,可记忆的金属,陶瓷,骨骼,生物可吸收物和合成物。
移植物可由有记忆的金属组成,其可以在被插入椎间盘空间后扩展。构架可以在活的有机体内扩展。
移植物可以被作为标准部件使用,其被附着或装配在两移植物间产生一种结构型(ALIF型)的构架。
移植物可以被一个接一个堆砌在一起,形成一有各种形状和大小的椎体切除术中的构架。
移植物被设计成可以插入机器螺纹的螺丝钉,这样有利于加强所附着的棍或平板状系统的稳定性。
参照优选实施例已经对本发明做了描述。这些和其它的优选实施例以及本发明的其它实施例的修改是显而易见的。前述的优选实施例中说明仅用来解释本发明不对本发明做限制。目前所有涉及包括本发明的改进和替代都属于本发明权利要求的范围内。
Claims (32)
1.一种修复移植物,其在脊柱中的相邻椎骨之间形成一种刚性结构,包括一构架,构架有顶壁,底壁,前端壁,后端壁,第一侧壁和第二侧壁构成,所述的第一侧壁和第二侧壁沿所述的构架的纵轴方向充分地延伸,所述的前端壁和后端壁的宽度小于所述的第一侧壁和第二侧壁的长度,所述的顶壁和所述的底壁被定位在相邻的椎骨间并且与相邻的椎骨表面相咬合,所述的第一侧壁具有一弓形表面。
2.如权利要求1所述的修复移植物,其中顶壁包括至少一个突起与相连接的椎骨表面相啮合。
3.如权利要求1所述的修复移植物,其中所述的底壁至少包括一个突起与相邻的椎骨表面相啮合。
4.如权利要求2所述的修复移植物,其中所述的顶壁包括多个突起。
5.如权利要求2所述的修复移植物,其中至少一个所述的突起包括多个齿。
6.如权利要求2所述的修复移植物,其中所述的突起与所述的第一侧壁或第二侧壁的外围边缘分隔开。
7.如权利要求1所述的修复移植物,其中所述的顶壁包括一通孔,用于接收填充物质,所述的填充物质从包括药物,人体组织,动物组织,合成组织,人体细胞,动物细胞,合成细胞及其化合物的组合中选择。
8.如权利要求1所述的修复移植物,其中所述的底壁包括一通孔,用于接收填充物质,所述的填充物质从包括药物,人体组织,动物组织,合成组织,人体细胞,动物细胞,合成细胞及其化合物的组合中选择。
9.如权利要求1所述的修复移植物,其中所述的顶壁有一外围边,至少所述的外围边的一部分轮廓不是尖锐的。
10.如权利要求1所述的修复移植物,其中所述的底壁有一外围边,至少所述的外围边的一部分轮廓不是尖锐的。
11.如权利要求1所述的修复移植物,其中所述的顶壁从所述的第二侧壁向所述的第一侧壁方向倾斜。
12.如权利要求1所述的修复移植物,其中所述的底壁从所述的第二侧壁向所述的第一侧壁方向倾斜。
13.如权利要求1所述的修复移植物,其中所述的顶壁从所述的后端壁向所述的前端壁方向倾斜。
14.如权利要求1所述的修复移植物,其中所述的底壁从所述的后端壁向所述的前端壁方向倾斜。
15.如权利要求1所述的修复移植物,其中所述的后端壁高于所述的前端壁。
16.如权利要求1所述的修复移植物,其中所述的第一侧壁包括一通孔,用于接收填充物质,所述的填充物质从包括药物,人体组织,动物组织,合成组织,人体细胞,动物细胞,合成细胞及其化合物的组合中选择。
17.如权利要求1所述的修复移植物,其中所述的第二侧壁包括一通孔,用于接收填充物质,所述的填充物质从包括药物,人体组织,动物组织,血,干细胞及其化合物的组合中选择。
18.如权利要求1所述的修复移植物,其中所述的前端壁,所述的后端壁,所述的第一侧壁和所述的第二侧壁上中至少一个具有通孔,所述的通孔适合于接收一器械在脊柱中相邻的椎骨间引导所述的修复移植物,和接收一移植物,确保所述的构架相对所述的椎骨及其化合物定位。
19.如权利要求1所述的修复移植物,其中所述的第一侧壁是一十分标准的弓形表面。
20.一种修复移植物,其在脊柱中的相邻椎骨之间形成一种刚性结构,包括一构架,构架有顶壁,底壁,前端壁,后端壁,第一侧壁和第二侧壁构成,所述的第一侧壁和第二侧壁沿所述的构架的纵轴方向充分地延伸,所述的前端壁和后端壁的宽度小于所述的第一侧壁和第二侧壁的长度,所述的顶壁和所述的底壁被定位在相邻的椎骨间并且与相邻的椎骨表面相咬合,所述的顶壁和底壁中至少有一面从所述的第二侧壁向所述的第一侧壁方向倾斜。
21.如权利要求20所述的修复移植物,其中所述的顶壁和所述的底壁都从所述的第二侧壁向所述的第一侧方向壁倾斜。
22.如权利要求20所述的修复移植物,其中所述的第二侧壁高于所述的第一侧壁。
23.如权利要求20所述的修复移植物,其中所述的顶壁和底壁包括多个突起与相邻的椎骨表面啮合。
24.如权利要求23所述的修复移植物,其中所述的突起包括多个齿。
25.如权利要求20所述的修复移植物,其中所述的突起与所述的第一侧壁和第二侧壁的外围边分隔开。
26.如权利要求20所述的修复移植物,其中所述的顶壁和底壁包括一通孔,用于接收填充物质,所述的填充物质从包括药物,人体组织,动物组织,合成组织,人体细胞,动物细胞,合成细胞及其化合物的组合中选择。
27.如权利要求20所述的修复移植物,其中所述的顶壁,底壁,前端壁,后端壁,第一侧壁和第二侧壁纸的每一个壁都具有一外围边,所述的每一个壁的所述的外围边的至少一部分的轮廓不是尖锐的。
28.如权利要求20所述的修复移植物,其中所述的顶壁和底壁从所述的后端壁向所述的前端壁方向倾斜。
29.如权利要求20所述的修复移植物,其中所述的后端壁高于所述的前端壁。
30.如权利要求20所述的修复移植物,其中所述的前端壁,所述的后端壁,所述的第一侧壁和所述的第二侧壁上中至少一个具有通孔,所述的通孔适合于接收一器械,在脊柱中相邻的椎骨间引导所述的修复移植物,和接收一移植物,确保所述的构架相对所述的椎骨及其化合物定位。
31.如权利要求30所述的修复移植物,其中在所述的构架内包括一腔,所述的腔至少与所述的前端壁,所述的后端壁,所述的第一侧壁和所述的第二侧壁上的所述的至少一通孔相通,所述的腔适合接收填充物质,该填充物质从包括药物,人体组织,动物组织,合成组织,人体细胞,动物细胞,合成细胞及其化合物的组合中选择。
32.如权利要求20所述的修复移植物,其中所述的前端壁有一十分标准的弓形表面。
Applications Claiming Priority (2)
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US09/494,645 US6245108B1 (en) | 1999-02-25 | 2000-01-31 | Spinal fusion implant |
US09/494,645 | 2000-01-31 |
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CN1388750A true CN1388750A (zh) | 2003-01-01 |
CN1209078C CN1209078C (zh) | 2005-07-06 |
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CNB018023444A Expired - Fee Related CN1209078C (zh) | 2000-01-31 | 2001-01-18 | 脊柱融合移植物 |
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EP (1) | EP1416891A4 (zh) |
JP (1) | JP2003521315A (zh) |
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CN (1) | CN1209078C (zh) |
AU (1) | AU772498B2 (zh) |
BR (1) | BR0107858A (zh) |
CA (1) | CA2383634C (zh) |
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CN100349558C (zh) * | 2004-01-05 | 2007-11-21 | 贾连顺 | 帽式颈椎椎间融合器 |
CN101002703B (zh) * | 2007-01-23 | 2012-06-13 | 成都军区昆明总医院 | 可吸收椎体内支撑器 |
CN103079499A (zh) * | 2010-08-11 | 2013-05-01 | 华沙整形外科股份有限公司 | C1-c2植入物及其使用方法 |
CN103079499B (zh) * | 2010-08-11 | 2015-11-25 | 华沙整形外科股份有限公司 | C1-c2植入物及其使用方法 |
CN107625564A (zh) * | 2017-10-20 | 2018-01-26 | 常州华森医疗器械有限公司 | 腰椎椎间融合器 |
CN108514465A (zh) * | 2018-06-12 | 2018-09-11 | 深圳市立心科学有限公司 | 填充有人工骨的椎间融合器 |
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CA2383634A1 (en) | 2001-08-02 |
US20010016777A1 (en) | 2001-08-23 |
US20020143400A1 (en) | 2002-10-03 |
KR100488032B1 (ko) | 2005-05-06 |
NZ518272A (en) | 2004-01-30 |
AU772498B2 (en) | 2004-04-29 |
US7229477B2 (en) | 2007-06-12 |
JP2003521315A (ja) | 2003-07-15 |
CA2383634C (en) | 2006-03-28 |
AU3647301A (en) | 2001-08-07 |
US6245108B1 (en) | 2001-06-12 |
BR0107858A (pt) | 2002-10-29 |
US6676703B2 (en) | 2004-01-13 |
KR20020064879A (ko) | 2002-08-10 |
MXPA02006629A (es) | 2005-11-23 |
WO2001054629A1 (en) | 2001-08-02 |
CN1209078C (zh) | 2005-07-06 |
EP1416891A4 (en) | 2007-01-31 |
EP1416891A1 (en) | 2004-05-12 |
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