CN1665459A - 具有三部分关节的椎间植入物 - Google Patents

具有三部分关节的椎间植入物 Download PDF

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CN1665459A
CN1665459A CN028295404A CN02829540A CN1665459A CN 1665459 A CN1665459 A CN 1665459A CN 028295404 A CN028295404 A CN 028295404A CN 02829540 A CN02829540 A CN 02829540A CN 1665459 A CN1665459 A CN 1665459A
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intervertebral implant
joint
pivot center
inner concave
central axis
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CN100548239C (zh
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D·鲍姆加特纳
A·布里
C·马蒂厄
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AO Technology AG
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MARS MEDICAL TECHNOLOGY AG
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Abstract

本发明涉及一种椎间植入物，具有一基本上平行于或共轴于脊椎柱纵轴线的中心轴线(1)，并且包括：A)一个上接头和一个下接头(2、3)，各具有一横向于中心轴线(1)并分别支承在两邻接的椎骨体的两端面之一个上的外表面(5、6)，并且各具有一个相互面向的内凹面(7、8)；B)一个在接头(2、3)之间定位的凸面的关节体(4)，其可滑动地贴紧两接头(2、3)的内凹面(7、8)；C)第一内凹面(7)为一个关于第一横向于中心轴线(1)的转动轴线(12)旋转对称的圆周表面(11)的部分表面；以及D)第二内凹面(8)为一个关于第二横向于中心轴线(1)的转动轴线(14)旋转对称的圆锥圆周表面(16)的部分表面。

Description

具有三部分关节的椎间植入物
本发明涉及一种按照权利要求1前序部分所述的椎间植入物。
在排除损伤的自然的椎间盘或损伤的椎间盘核以后，将植入物或假体插入两邻接的椎骨体的椎间空隙内。其目的在于，重新尽可能导致自然的状态，亦即特别是恢复原来的椎间盘高度并从而恢复两邻接的椎骨体之间的原来的间距。此外应该可以尽可能无妨碍地以其自然的方式实现邻接的椎骨体的相互相对运动。为此重要的是，在向前/向后倾斜、亦即椎骨体的屈曲和伸展时以及在椎骨体的侧面的弯曲时保持在自然的限度以内的运动可能性。应该使邻接的椎骨体相互相对的扭转同样能够在自然的限度以内。
由BTTNER的EP 0 176 728已知一同一种的椎间盘内假体。该已知的椎间盘内假体基本上包括两个对称的凹面的端接板，其外表面可分别支承在邻接的椎骨体的一个终板上，并且包括一凸面的隔板。其定位在各端接板的相互对置设置的凹面侧面之间。该已知的椎间盘内假体不利的是，
—用于邻接的椎骨体的屈曲/伸展和用于其侧面的弯曲的各转动轴线通过各端接板之间的关节式连接只在某一范围内是确定的并且不符合于自然的生理状态；
—侧面的和前面的/背面的运动间隙是相同的，因为具有外嵌体(Pe-Inlay)的假体具有旋转对称的形状。自然的运动间隙的平均值，亦即各端接板绕横向于脊椎柱纵轴线延伸的转动轴线的转角的平均值对于屈曲为10°，对于伸展为5°而对于侧面为7°；
—假体未包括用于各端接板绕一共轴于或平行脊椎柱纵轴线的转动轴线的相对转动(椎骨体的扭转运动)的运动限制装置；以及
—假体在受冲击作用时只保证微小的缓冲。
在这里本发明将消除上述弊端。本发明的目的在于，提供一种椎间植入物，其包括各一个确定的转动轴线用于脊椎柱的侧面运动和用于邻接的椎骨体的屈曲和伸展，其中两转动轴线相交并在相对于中心轴线成不同的角度延伸。
本发明利用一种椎间植入物，特别是利用具有权利要求1的特征的椎间植入物达到提出的目的。
本发明的椎间植入物包括一基本上平行于或共轴于脊椎柱纵轴线的中心轴线；一下接头和一上接头，其具有各一个横向于中心轴线定向的外表面和各一个相互对置的内凹面；以及一在各接头之间可在内凹面上滑动定位的关节体。各接头的外表面可分别支承在两邻接的椎骨体的两端面之一个上。在上接头上设置的第一内凹面构成为一关于第一横向于中心轴线延伸的转动轴线旋转对称的圆周表面的部分表面。在下接头上设置的第二内凹面构成为一关于第二横向于中心轴线延伸的转动轴线旋转对称的圆锥圆周表面的部分表面，从而第二转动轴线重合于锥体的纵轴线。
以下假定下接头作为固定的而关节体和上接头作为可运动的。因此第二转动轴线同样是固定的，其由第二关于第二转动轴线旋转对称的内凹面确定并从而相对于下接头是固定的，而当使关节与上接头一起绕第二转动轴线转动时第一转动轴线与关节体和上接头一起绕第二转动轴线转动，该第一转动轴线由第一关于第一转动轴线旋转对称的内凹面确定并从而相对于上接头是固定的。中心轴线以下同样看作相对于下接头是固定的。
在本发明的椎间植入物的优选的实施形式中两转动轴线相交，优选转动轴线与中心轴线相交。
通过本发明达到的优点基本上在于，由于本发明的椎间植入物两转动轴线可以位于两个不同的横向于中心轴线的平面内。按这种方式脊椎柱的侧面的弯曲的转动轴线和脊椎柱的伸展或屈曲的转动轴线可以相互相对位错并且设置在位于不平行的各平面内。通过这样的构造可以精确地复制各自然的转动轴线的位置，借此两邻接的椎骨体的生物力学在相当大程度上接近脊椎柱的健全的状态或其完全是可重新建立的。由于考虑到生理的转动中心，因此在保持转动中心与力介入点之间的间距的情况下没有提高的力矩出现在韧带、腱和肌肉上。
在本发明的椎间植入物的另一实施形式中，关节体的各滑动面设计成不互补于各接头的内凹面，从而在各滑动面与两接头的各内凹面之间构成点式的或线式的接触。具有线式接触的构造例如可这样实现，即关节体上的各滑动面具有比邻接的接头的内凹面较小的曲率半径。在第一内凹面与关节体上的邻接的滑动面之间的点式接触可以例如通过关节体上的滑动面的球体的、旋转椭圆体式的或桶式的构造和同样按照第一内凹面的实施形式来构成。
在本发明的椎间植入物的又一实施形式中，关节体包括至少一个横向于中心轴线设置的凸出的滑动面，其构成互补于邻接的接头的内凹面。优选两滑动面设计成互补于各接头的内凹面，其中第一滑动面构成互补于上接头的内凹面而第二滑动面构成互补于下接头的内凹面。其中第一内凹面和第一滑动面构成为一关于第一横向于中心轴线的转动轴线旋转对称的圆周表面的部分表面并且构成第一可绕第一转动轴线转动的关节的滑动面。第二内凹面和第二滑动面构成为一锥体圆周表面的部分表面，其构成第二可绕第二转动轴线转动的关节的滑动面，其中第二转动轴线相当于圆锥的纵轴线。
在本发明的椎间植入物的另一实施形式中，两转动轴线设置成使第二转动轴线位于一包含中心轴线的平面内，该平面由第一转动轴线穿过。借此可达到的优点是，第一转动轴线并因而脊椎柱的屈曲和伸展的转动轴线在不绕第二转动轴线转动的关节体中垂直于椎间植入物的中心轴线延伸。第二转动轴线用作为脊椎柱的侧面的弯曲并且可以与中心轴线包含一适合于自然运动的角度α。优选该角度α在60°与88°之间。通过角度α的选择可以根据椎间盘高度复制按照生理学的腰部的脊椎柱的不同的段。
在本发明的椎间植入物的又一实施形式中，关于第一转动轴线旋转对称的圆周表面构成为圆柱圆周表面。因此在一接头上的第一内凹面和在关节体上的第一滑动面构成为一圆柱圆周表面的部分表面，因此第一关节只关于第一转动轴线是可转动的。借此能够实现一特定的屈曲/伸展运动。此外，单独地考虑这样的运动情况成为可能的，因为用于侧面的弯曲的转动轴线另外设置。
代替关于第一转动轴线旋转对称的圆周表面作为圆柱圆周表面的设计，作为圆锥圆周表面的构造也是可能的。关于第一转动轴线旋转对称的圆周表面的其他的构造可能性例如是一旋转椭圆体的、一双圆锥的或同样一其他任何的旋转体的表面部分。
在本发明的椎间植入物的另一实施形式中，第一转动轴线与中心轴线相交，从而在脊椎柱屈曲或伸展时两邻接椎间植入物的椎骨体的转动中心位于椎间植入物的中心轴线上。第二关节的第二转动轴线同样与中心轴线相交。其中两转动轴线相互间具有一最小的间距A。优选该间距A在0mm与18mm之间。该间距A产生于转动中心的解剖学条件，例如产生于这样的事实，即用于侧面的弯曲的转动轴线对角地朝背侧的方向下降地在人体的中平面内延伸。
在本发明的椎间植入物的另一实施形式中，各接头的外表面设有一三维的构造，其例如通过使表面变粗糙是可达到的并且有助于邻接的椎骨体在椎间植入物上的生长。
在本发明的椎间植入物的另一实施形式中，代替三维的构造在各接头的外表面上设置一网格，优选一钛网格，借此再次有助于椎骨体的终板在椎间植入物上的生长。
在本发明的椎间植入物的又一实施形式中，至少一个接头包括第一和第二止挡装置，借其限定各接头的相互相对运动。这些止挡装置用于限定各接头绕第一转动轴线的相对转动，借此能够实现邻接椎骨体的屈曲和伸展。优选通过第三止挡装置限制邻接椎间植入物的椎骨体的侧面的弯曲。这些第三止挡装置限定各接头绕第二转动轴线的相对转动。止挡装置设计成使其允许邻接的椎骨体的最大屈曲在5°与15°之间，最大伸展在2°与15°之间和最大侧面的弯曲在±5°与±10°之间。
在本发明的椎间植入物的一个实施形式中，一个接头构造成三部分的。该接头包括一外面的盖板、一包括内凹面的关节外壳和一在中间的横向于中心轴线设置的可弹性变形的接合部分。通过该可弹性变形的接合部分的嵌入可达到的优点是，一方面可抑制两邻接的椎骨体的压缩运动而另一方面在椎间植入物的两接头之间的剪切运动和扭转运动是可能的。
在诸从属权利要求中表明了本发明的其他有利的构造的特征。
以下还要借助多个实施例的部分示意图更详细地说明本发明和本发明的进一步构成。其中：
图1  本发明的椎间植入物的一个实施形式的分解图；
图2  关节体的透视图，其包括图1中所示的本发明的椎间植入物的实施形式的包含滑动面的旋转对称于转动轴线的各圆周表面；
图3  本发明的椎间植入物的一个实施形式的侧视图；
图4  图3中所示的本发明的椎间植入物的后视图；以及
图5  本发明的椎间植入物的另一实施形式的分解图。
图1中示出本发明的椎间植入物的一个实施形式，其包括一上面的和一下面的相交于中心轴线1的接头2、3和一同样相交于中心轴线1的定位在接头2、3之间的关节体4。两接头2、3各具有一配合于邻接的椎骨体的终板的和横向于中心轴线1的外表面5、6，其可分别支承在两邻接的椎骨体的相互对置的端面之一个上，两接头2、3各包括一个相互面向的内凹面7、8，而关节体4具有两个凸出的滑动面9、10，其中一凸出的滑动面9互补于上接头2的内凹面7而另一凸出的滑动面10互补于下接头3的内凹面8。第一内凹面7和与其互补的第一滑动面9构成在关节体4与上接头2之间的可绕第一转动轴线12转动的第一关节的滑动面。如果关节体4位于其原始位置，亦即未被绕第二转动轴线14转动，则第一转动轴线12垂直于中心轴线1。上接头2绕第一转动轴线12的转动实现邻接接头2、3的椎骨体的屈曲运动或伸展运动。上接头2上的第一内凹面7和与其互补的关节体4上的第一滑动面9在图中所示的本发明的椎间植入物的实施形式中构成为一旋转对称于第一转动轴线12的圆柱圆周表面的部分表面。第二内凹面8和与其互补的第二滑动面10构成在关节体4与下接头3之间的可绕第二转动轴线14转动的第二关节。该第二转动轴线14以角度α与中心轴线1相交，但不与第一转动轴线12相交。如图2中所示，第二转动轴线14位于一包含中心轴线1的平面17内，该平面由第一转动轴线12穿过。因此关节体4与上接头2一起绕第二转动轴线14的转动能够实现两邻接椎间植入物的椎骨体的侧面的弯曲。此外由图2显而易见的是，关于第一转动轴线12旋转对称的圆周表面11为一圆柱圆周表面，第一滑动面9构成其一部分。第二滑动面10为一旋转对称于第二转动轴线14的圆锥圆周表面16的一部分。此外两转动轴线相互间具有一间距A。如图2中所示，在关节体4绕第二转动轴线转动时第一转动轴线12在一同心于中心轴线1与第二转动轴线14之间的交点15的半径为A的圆弧13上运动。
图3中示出本发明的椎间植入物的一个实施形式，其与图1中所示的实施形式的区别在于，上接头2构成三部分的。上接头2包括一在轴向外面的包括上外表面5的盖板24、一指向关节体4的关节外壳26和一在关节外壳26与盖板24之间的可弹性变形的接合部分25。此外椎间植入物具有一指向锥顶18的前面19和一与其对置的后面20。椎间植入物设计成使前面19在植入椎间空隙以后在后面定位。借此使第二转动轴线14从前面向后面延伸。通过两止挡装置21、22限定上接头2绕垂直于图面的第一转动轴线12(图1)的转动。其中第一止挡装置21设置在上接头2的前面19上，用作为两接头2、3的平行于中心轴线1缩短前面19的相互相对转动的一个界限并从而限制两邻接的椎骨体的伸展运动，而第二止挡装置22用作为两接头2、3的平行于中心轴线1缩短后面20的相互相对转动的一个界限并限制两邻接的椎骨体的屈曲运动。第一和第二止挡装置21、22通过上接头2的在前面19或后面20上的下端32、33构成，其在达到最大允许的转角以后贴紧在下接头3的底板30的指向关节体4的内表面31上。如图4中所示，后面20(图3)上的下端33是倒圆的，其中该倒圆弧的中心重合于第二转动轴线14(图3)与椎间植入物的后面20的交点，从而第一止挡装置22在已绕第二转动轴线14(图3)转动的上接头2中以绕第一转动轴线12的同一转角支承在下接头3的底板30的内表面31上。此外在关节体4上第二滑动面10(图1)在其周边的一部分上和在其长度的一部分上在椎间植入物的后面20旁边凹进。类似于此凹进第二内凹面8。通过该台阶构成的各第三止挡装置23限定上接头2绕第二转动轴线14的转角，从而借此限制两邻接椎间植入物的椎骨体的侧面的弯曲。止挡装置21、22、23设计成使允许邻接的椎骨体屈曲10°的角度β、伸展5°的角度γ和侧面弯曲±7°的角度δ。
图5中所示的本发明的实施形式与图1、3或4中所示的实施形式的区别只在于，在盖板24和底板30的外面上设置格网27并且第一凸出的滑动面9包括一同心于第一转动轴线12的凸起部分28而第一内凹面7包括一凹槽29，其中在上接头2相对于关节体4转动时凸起部分28切向移进凹槽29内。凸起部分28只沿第一滑动面9的一部分平行于第一转动轴线12延伸而凸起部分28的周长沿整个的第一滑动面9延伸。在第一内凹面29中的凹槽29构成互补于该凸起部分。在本发明的椎间植入物的其他的实施形式中凸起部分28也可以具有只在第一滑动面9的一部分上的周长。该嵌入凹槽29内的凸起部分28的优点在于，一方面可达到第一接头2与关节体4之间的侧面的稳定性。防止邻接的椎骨体平行于第一转动轴线12的剪切运动，而另一方面可达到关节体4在椎间植入物内的定心，从而关节体4不可能平行于第一转动轴线12相对于第一接头2移动。格网27优选制成为钛网并且也可以构成弧形的，借此使邻接的椎骨体在椎间植入物上能够达到最好的生长。

Claims (17)

1.椎间植入物，具有一基本上平行于或共轴于脊椎柱纵轴线的中心轴线(1)，并且包括：
a)一个上接头和一个下接头(2、3)，其具有各一个横向于中心轴线(1)设置的外表面(5、6)和各一个相互对置的内凹面(7、8)；以及
b)一个在接头(2、3)之间定位的凸面的关节体(4)，其可滑动地贴紧两接头(2、3)的内凹面(7、8)；
其特征在于，
c)第一内凹面(7)为一个关于一横向于中心轴线(1)的第一转动轴线(12)旋转对称的圆周表面(11)的部分表面；以及
d)第二内凹面(8)为一个关于一横向于中心轴线(1)的第二转动轴线(14)旋转对称的圆锥圆周表面(16)的部分表面。
2.按照权利要求1所述的椎间植入物，其特征在于，第一转动轴线(12)与第二转动轴线(14)相交。
3.按照权利要求1或2所述的椎间植入物，其特征在于，关节体(4)包括至少一个与中心轴线(1)相交的凸出的滑动面(9、10)。
4.按照权利要求3所述的椎间植入物，其特征在于，第一内凹面(7)和凸面的贴紧关节体(4)的滑动面(9)的曲率半径是不同的，并且滑动面(7)构造成球体的、椭圆体式的或桶式的，从而在凸面的关节体(4)与第一内凹面(7)之间可构成点接触。
5.按照权利要求3所述的椎间植入物，其特征在于，在凸面的关节体(4)上的至少一个滑动面(9、10)和两接头(2、3)的至少一个内凹面(7、8)的内率半径是不同的，从而在凸面的关节体(4)与一个或两个内凹面(7、8)之间可构成线接触。
6.按照权利要求3所述的椎间植入物，其特征在于，关节体(4)的第一滑动面(9)互补于上接头(2)的内凹面(7)，并且内凹面(7)与第一滑动面(9)一起构成可绕第一转动轴线(12)转动的一第一关节的滑动面。
7.按照权利要求3或6所述的椎间植入物，其特征在于，关节体(4)的第二滑动面(10)互补于下接头(3)的内凹面(8)，并且内凹面(8)与第二滑动面(10)一起构成可绕第二转动轴线(14)转动的一第二关节的滑动面。
8.按照权利要求1至7之一项所述的椎间植入物，其特征在于，第二转动轴线(14)以角度α与中心轴线(1)相交，角度α在60°与88°之间。
9.按照权利要求1至8之一项所述的椎间植入物，其特征在于，旋转对称的圆周表面(11)为一圆柱圆周表面。
10.按照权利要求1至8之一项所述的椎间植入物，其特征在于，旋转对称的圆周表面(11)为一第二圆锥圆周表面。
11.按照权利要求1至10之一项所述的椎间植入物，其特征在于，第一转动轴线(12)和第二转动轴线(14)相互间具有一最小间距A。
12.按照权利要求11所述的椎间植入物，其特征在于，间距A在0mm与18mm之间。
13.按照权利要求1至12之一项所述的椎间植入物，其特征在于，外表面(5、6)具有一种三维的构造。
14.按照权利要求1至13之一项所述的椎间植入物，其特征在于，外表面(5、6)为钛网格，其可与接头(2、3)连接。
15.按照权利要求1至14之一项所述的椎间植入物，其特征在于，
a)圆锥圆周表面(16)包括一个处在第二转动轴线(14)上的锥顶；
b)椎间植入物具有一个指向锥顶(18)的前面(19)和一相反的后面(20)；
c)至少一个接头(2、3)包括第一止挡装置(21)，其将平行于中心轴线(1)缩短椎间植入物的前面(19)的绕第一转动轴线(12)的转动限定在5°与15°之间的角度β；以及
d)至少一个接头(2、3)包括第二止挡装置(22)，其将平行于中心轴线(1)缩短椎间植入物的背面(20)的绕第一转动轴线(12)的转动限定在2°与15°之间的角度γ。
16.按照权利要求1至15之一项所述的椎间植入物，其特征在于，它包括第三止挡装置(23)，其将绕第二转动轴线(14)的转动限定在±5°与±10°之间的最大转角δ。
17.按照权利要求1至16之一项所述的椎间植入物，其特征在于，接头(2、3)中的至少一个构造成三部分的，并且包括一外面的盖板(24)、一包括内凹面(7、8)的关节外壳(26)和一在中间的可弹性变形的接合部分(25)。
CNB028295404A 2002-09-02 2002-09-02 具有三部分关节的椎间植入物 Expired - Fee Related CN100548239C (zh)

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CA2497278A1 (en) 2004-03-11
EP1534193B1 (de) 2006-07-05
ES2269743T3 (es) 2007-04-01
KR20060011815A (ko) 2006-02-03
DE50207457D1 (de) 2006-08-17
AU2002322960A1 (en) 2004-03-19
US20060036326A1 (en) 2006-02-16
AU2002322960B2 (en) 2006-05-25
JP2005537053A (ja) 2005-12-08
US7597713B2 (en) 2009-10-06
EP1534193A1 (de) 2005-06-01
CA2497278C (en) 2010-05-11
JP4210647B2 (ja) 2009-01-21
ATE332115T1 (de) 2006-07-15
WO2004019828A1 (de) 2004-03-11
KR100918925B1 (ko) 2009-09-28
CN100548239C (zh) 2009-10-14

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