CN100594854C - 扩展的体间植入物和铰接的插入物及其方法 - Google Patents
扩展的体间植入物和铰接的插入物及其方法 Download PDFInfo
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- CN100594854C CN100594854C CN200480006058A CN200480006058A CN100594854C CN 100594854 C CN100594854 C CN 100594854C CN 200480006058 A CN200480006058 A CN 200480006058A CN 200480006058 A CN200480006058 A CN 200480006058A CN 100594854 C CN100594854 C CN 100594854C
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- parts
- feeding mechanism
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- slope
- orientation
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Abstract
一处理脊椎件的装置具有一间隔件(10)、一供应装置(80)和一展开器(7)。间隔件(10)至少包括第一和第二部件(20、30),第一部件(20)具有至少一个倾斜部分(25、26)和一接触表面(27、28),而第二部件(30)具有至少一个倾斜部分和一接触表面。供应装置(80)附连到第一部件(20)和第二部件(30)中的至少一个上。第一和第二部件(20、30)相对于彼此可移动,以使倾斜部分接触并扩展装置的高度。该装置定位在具有一第一高度的第一关闭定向和具有一第二高度的第二打开定向之间,第二高度大于第一高度,且其间是逐步变化的。本文还揭示了使用间隔件来间隔脊椎件的方法。
Description
相关申请
本申请根据35U.S.C§119(e)要求对以下美国临时申请的优先权:2003年2月3日提交的申请系列号No.60/444,561的申请。本申请全文引用其内容以供参考。
背景技术
医学上采用各种装置来控制脊椎件之间的间隔。这些装置可用于临时的目的,例如,在需要进入脊椎件的特定表面内时的外科手术过程中。其一个实例可包括准备脊椎件的端板。这些装置也可永久地留在病人体内以间隔脊椎件。
通常难于以最小创伤的方式在脊椎件之间定位这种装置。体积小的装置可以最小创伤方式插入病人体内的脊椎件之间。然而,小的体积不能足以有效地间隔脊椎件。体积大的装置可以有效地间隔脊椎件,但不能以最小创伤方式插入病人体内的脊椎件之间。
发明内容
本发明涉及一用来在邻近脊椎件之间定位的装置。在一实施例中,装置通常包括一间隔件、一供应装置以及一展开器。间隔件定位在相邻的脊椎件之间,并有选择地在一关闭定向和打开定向之间进行调整,它们之间是逐级调整的。供应装置将间隔件定位在病人体内,而展开器将间隔件移动到选定的定向。
在一实施例中,间隔件有选择地定位在一具有最小高度的第一定向和一具有最大高度的第二定向之间,而选定位置在这两者之间。该装置可包括一第一部件和一第二部件,前者具有一沿第一方向延伸的第一倾斜表面,而后者具有一沿第二方向延伸的第二倾斜表面。当第一部件相对于第二部件移动时,倾斜表面彼此接触且间隔件的尺寸增大。该装置可定位在供应装置上,这样,当手术完成之后,它可从病人体内移去,或从供应装置中拆下而保留在病人体内,既可以永久地也可保持一预定的时间。
在一使用该装置的实施例中,装置定位在两个脊椎件之间。在定位过程中,装置处于一具有小尺寸的关闭的定向,以便于以最小创伤插入病人体内。间隔件可以相对于供应装置倾斜而将间隔件定位在脊椎件之间。一旦定位后,间隔件的部分相对于彼此移动以使倾斜表面彼此接触。部件的接触和移动致使间隔件的总高度增加。间隔件可以定位在各种高度内,视其应用而定。在某些实施例中,间隔件包括一锁定装置,其将间隔件锁定在一高度上并防止间隔件关闭。
附图的简要说明
图1是本发明的一实施例的立体图;
图2是根据本发明的一实施例的处于关闭定向的间隔件的立体图;
图3是根据本发明的一实施例的处于打开定向的间隔件的立体图;
图4是根据本发明的一实施例的间隔件的分解的立体图;
图5是根据本发明的一实施例的第一部件的立体图;
图6是根据本发明的一实施例的处于第二部件内的一第一位置的第三部件的立体图;
图7是根据本发明的一实施例的处于第二部件内的一第二位置的第三部件的立体图;
图8是根据本发明的一实施例的锁定机构的局剖的立体图;
图9是根据本发明的一实施例的与第二部件接触的第一部件的立体图;
图10是根据本发明的一实施例的相对于供应装置倾斜的间隔件的局部的立体图;
图11是根据本发明的一实施例的相对于供应装置倾斜的间隔件的另一实施例的局部的立体图;
图12是根据本发明的一实施例的与供应装置脱开的间隔件的局部的立体图;
图13是根据本发明的一实施例的处于第一定向的保持器和枢轴的局部的立体图;
图14是根据本发明的一实施例的处于第二定向的保持器和枢轴的局部的立体图;
图15是根据本发明的一实施例的相对于供应装置倾斜的间隔件的另一实施例的局部的立体图;
图16是根据本发明的一实施例的本发明的立体图;
图17是根据本发明的一实施例的装置的一部分的局部立体图;
图18是示出根据本发明的一实施例的处于第二部件内的一第一位置的第三部件的局部的立体图;
图19是示出根据本发明的一实施例的处于第二部件内的一第二位置的第三部件的局部的立体图;
图20是根据本发明的一实施例的锁定装置的局部立体图;
图21是根据本发明的一实施例的活动枢轴的局部立体图;
图22是根据本发明的一实施例构造的第三部件的另一实施例的立体图;
图23是与根据本发明的一实施例构造的第三部件接触的凸轮的局部立体图;
图24是根据本发明的一实施例构造的另一供应装置和释放机构的局部立体图;
图25是附连到根据本发明的一实施例构造的供应装置的间隔件的局部立体图;
图26是根据本发明的一实施例构造的管套筒和凸轮的局部立体图;
图27是附连到根据本发明的一实施例构造的供应装置的间隔件的局部立体图;
图28是从根据本发明的一实施例构造的供应装置拆下的间隔件的局部立体图。
具体实施方式
本发明涉及一用来在邻近脊椎件之间定位的装置。图1示出一用标号9表示的实施例,其包括一间隔件10、一供应装置80,以及一展开器7。间隔件10定位在相邻的脊椎件之间,并有选择地在一关闭定向和打开定向之间进行调整,它们之间是逐级调整的。供应装置80将间隔件定位在病人体内。展开器7将间隔件移动到选定的扩展定向。
间隔件10具有各种形状和尺寸,视其应用而定,例如,细长形状、弧形形状。间隔件10可在如图2所示的第一位置调整,该位置具有一缩小的尺寸,当其插入到病人体内的脊椎件之间时,造成的创伤最小。图3示出一第二位置,此时,间隔件10扩展而接触脊椎件。间隔件10根据所要求的应用可以扩展到各种不同的高度。
图2和3示出一具有一圆形腰子形的间隔件10的实施例,其具有一远端的第一端11和一近端的第二端12,它们各具有一圆形的形状。第一和第二侧边13、14呈弧形。间隔件10可具有一基本上恒定的宽度,在一特定的实施例中该宽度约为33mm。间隔件10的高度可根据展开量进行变化,并用坡度表面的角度表示(将在下文中进行详细描述)。在一特定实施例中,间隔件10具有的高度范围在约9mm至13mm。在一实施例中,间隔件10倾斜在一个或多个的关闭、打开,或展开定向中,以适应于脊椎件的尺寸。
图4示出间隔件10的一实施例,其包括一第一部件20、一第二部件30,以及一第三部件40。第一部件20包括接触表面21,而第二部件30包括接触表面31,它们各接触一脊椎件。接触表面21、31可以基本上是光滑的,或可具有诸如突脊或硬节之类的稳定特征以便接触脊椎件。
第一和第二部件20、30具有互补的形状以便在关闭的定向中匹配在一起。部件20、30的向外边缘22、32相邻地定位在关闭的定向中,以减小间隔件10的总尺寸。当间隔件10处于关闭定向时,向外边缘32可接触或远离接触表面21的内边缘。侧边23、33从各接触表面延伸,并可具有各种不同的形状和尺寸来形成间隔件10的总体形状。
图5示出第一部件20的下面的一实施例。侧边23向外延伸以与第二部件30匹配。一短小突出29可从其中一个侧边23向外延伸,以与第二部件侧壁33内的一槽匹配,当间隔件10处于打开定向时,在展开的过程中可进一步起到稳定作用。短小突出29接触槽的上边缘(见图18),以在间隔件10展开过程中防止第一部件20与第二部件30分离。
第一部件20包括一第一倾斜部分25和一支承部分27,以及一第二倾斜部分26和支承部分28。倾斜部分25、26可具有各种长度,并可相对于接触表面21定位成各种角度。倾斜部分26、25可以呈相同的斜度,或可具有不同的角度。在一实施例中,部分25、26与接触表面21之间的角度范围在约20°至40°。支承部分27、28邻近于倾斜部分25、26定位,并相对于倾斜部分25、26定位成不同的角度。在一实施例中,支承部分27、28基本上平行于接触表面21。
第二部件30的形状与第一部件20互补。侧壁33围绕第二部件30的一部分或全部延伸,以便与第一部件20对齐并形成一内部部分来保持第三部件40。一内部部分39形成在侧壁33内并与接触表面31相对。在一如图7和8所示的实施例中,内部部分39基本上平而光滑,以便于第三部件40的相对运动。一框架93可从第二部件30延伸。定位在框架93上的两个孔37准许供应装置80进行附连(将在下文中描述)。
第三部件40定位在第一部件20和第二部件30之间。第三部件40包括一第一侧41和一第二侧42,前者具有与第一部件20匹配的倾斜部分45、46,后者接触第二部件30。第一侧41的一实施例示于图4中,其包括一第一倾斜部分45和相邻的支承部分47,以及一第二倾斜部分46和支承部分48。倾斜部分45、46可具有各种不同的长度,并可相对于第二侧42定位成各种角度。在一实施例中,部分45、46与第二侧42之间的角度范围在约20°至40°。支承部分47、48相对于倾斜部分45、46定位成不同的角度。在一实施例中,支承部分47、48基本上平行于第二侧42。在一实施例中,第二侧42平坦,其与内部部分39的平表面互补。
第三部件40可具有一宽度和长度,其小于或等于由第二部件30的侧壁33形成的边界。较小的尺寸提供第三部件40相对于第二部件30作滑动运动。第二和第三部件30、40的相对位置示于图6和7中。图6示出一第一位置,其中,第三部件40抵靠第二部件30的近端边缘定位。图7示出一第二位置,其中,第三部件40抵靠第二部件30的远端边缘定位。
第三部件40相对于第一和第二部件20、30移动,以使间隔件10从关闭定向展开到打开定向。间隔件10可以关闭的定向定位在病人体内,此时,其具有一最小的尺寸和形状而便于放置在病人体内的脊椎件之间。第一和第三部件20、40的倾斜部分25、26、45、46脱开而处于关闭的定向。
第三部件40相对于第一部件20移动可致使间隔件10展开。相对的运动导致第三部件40的倾斜部分45、46接触第一部件20的倾斜部分25、26。这致使第一部件20向外远离间隔件10的中心线移动。当第三部件40进一步移动时,倾斜部分继续相对于彼此滑动,而第一部件20继续向外离开中心线移动,从而增加间隔件10的总体高度。
图9示出处于全展开的打开位置的一实施例。第一部件20上的部分27、28接触和搁置在第三部件40的部分47、48上。在一实施例中,部分27、28、47、48比倾斜部分25、26、45、46倾斜得少一些,以防止间隔件10朝向关闭定向移动。倾斜部分25、26、45、46可具有相同的角度。
间隔件10的圆形导致第一和第三部件20、40的某些或全部的倾斜部分具有非对称的形状。在一如图5所示的实施例中,倾斜部分25、26在第一边缘13上具有的长度短于在第二边缘14上的长度。同样地,因为第二部件20的圆形,所以倾斜部分25、26不对齐。图6示出具有短于第二外边缘的一第一内边缘的倾斜表面45、46,且倾斜表面不对齐。
第一和第三部件20、40的倾斜表面25、26、45、46的坡度和尺寸可以变化,以便改变处于打开定向的间隔件10的形状。接触表面21和31可以倾斜,使间隔件10一端的高度大于另一端高度,或可沿打开定向基本上平行并逐步地打开。处于打开定向的间隔件10的形状可以顺从于脊骨的弧形。
在一实施例中,间隔件10包括各具有倾斜部分的两个部件,而没有第三部件。在展开过程中第一部件的倾斜部分接触第二部件的倾斜部分。各个部件还可包括平台部分以便在打开定向中进行接触。
间隔件10可沿第一和第二方向延伸。第三部件40包括在第二侧42上的倾斜部分,它们接触第二部件30的内部部分39上的倾斜部分。在一实施例中,第三部件40的运动导致第一部件20和第二部件30向外远离间隔件10的中心线移动。
另一实施例的特征在于一个或多个倾斜部分25、26、45、46具有一台阶的构造。台阶形构造的特征使得具有一个或多个台阶的倾斜部分绕其定位成倾斜不同的角度。诸台阶沿着倾斜部分25、26、45、46定位,以将间隔件10展开到不同的程度。各种台阶表面可以定位在诸部分上。在一实施例中,倾斜部分25、26、45、46各包括两个台阶使间隔件定位在一关闭定向、第一台阶上的第一定向、第二台阶上的第二定向和完全展开定向之间定位。
第一部件20和第二部件30还可各包括一单一的倾斜部分。间隔件10的运动导致仅单一倾斜表面接触。倾斜表面可以沿间隔件10的长度定位在任何点。在一实施例中,支承表面邻近于倾斜表面定位。
一锁定部件100可将间隔件10锁定在一特定的位置。在一如图8所示的实施例中,锁定部件100包括一对被偏置部件108分开的帽102(为了清晰起见,图8表征第三部件40已移去)。各个帽102包括一延伸部106,其尺寸适于配合在定位在第一部件20或第二部件30内的诸孔内。在一实施例中,一对孔35定位在第三部件30上以便接纳锁定部件100。当第三部件40相对于第二部件20移动时,锁定部件100延伸入一个或多个孔35内。在一实施例中,诸孔定位成在间隔件100处于打开定向且支承部分接触时用来接纳帽102。在另一实施例中,孔35定位成在倾斜表面接触时用来接纳帽102。锁定部件100防止第三部件40向外滑动和不留心减小间隔件的尺寸。在一在倾斜部分上具有台阶形构造的间隔件10中,成对的孔可以定位成在各级上锁定间隔件。在一实施例中,锁定机构100包括一配装在一单一孔内的单一的帽102。在此前提交的美国专利申请No.10/229,560中揭示了一间隔件,该专利申请于2002年8月28日提交,其题为“最小创伤的扩展间隔件及其方法”,该专利受让于本申请的同一实体,本文援引其全部内容以供参考。
供应装置80的功能在于将间隔件10定位在病人体内。供应装置80具有一细长的形状,以便外科医生将间隔件10定位在病人体内的脊椎件之间。在如图12所示的一实施例中,供应装置80具有细长形状,其尺寸使得一远端附连到间隔件10而一近端定位在病人的体外。供应装置80可具有各种横截面形状和尺寸,视其应用而定。供应装置80可以构造成一单一细长部件,或可构造成不同的部分。
供应装置80可以枢转的方式安装在间隔件上。图11示出供应装置80的一实施例,其包括一第一轴81和一第二轴82。一保持器55定位在轴82的远端处。保持器55包括活动枢轴90延伸通过的诸孔57。在一实施例中,倾斜边缘91顺从于间隔件框架93。一连接件54可枢转地安装在保持器55和第一轴81之间。第一轴81有选择地定位成围绕活动枢轴90枢转,因此,可相对于供应装置80枢转间隔件10。一支架56可形成在第一轴81的端部处,以便附连到连接件54上。
在一实施例中,间隔件10和供应装置80定位在如图11所示的第一定向。间隔件10的一纵向轴线300与供应装置80的一纵向轴线200形成一锐角α。在插入过程中,该定向使得间隔件10提供一减小的占据空间,这样,间隔件10以最小创伤方式定位在病人体内。在一实施例中,纵轴线300基本上与纵轴线200对齐(即,角α小于10度)。
间隔件10一旦定位在脊椎件之间,其相对于供应装置80枢转(如图15所示)。间隔件10相对于供应装置80枢转以使角α离第一定向增加。在一实施例中,角α增加到约75和110度之间。在一实施例中,通过相对于第二轴82移动第一轴81可造成铰接。保持器55连接到第二轴82,而第一轴81的相对运动致使保持器55围绕枢轴90枢转。轴81、82的相对运动量转变为间隔件10相对于供应装置80的铰接量或角度量。
间隔件10可以各种不同的方法相对于供应装置80铰接。在图16和17所示的一实施例中,一部件299轴向地与轴82的近端对齐。在一实施例中,部件299包括一螺纹部分和一非螺纹部分。轴81的近端包括抵靠非螺纹部分定位的延伸部131。轴81相对于部件299沿轴向移动。一驱动套筒130连接到轴81并定位在部件299上。驱动套筒130包括与部件299的螺纹部分啮合的内部螺纹。驱动套筒130的转动致使轴81相对于轴82作轴向运动,由此枢转间隔件10。在一实施例中,驱动套筒130通过一滑动环附连到第一轴81。
一旦合适地铰接和定位在脊椎件之间,间隔件10则从关闭定向朝向打开定向展开。一展开装置定位在供应装置80内以便展开间隔件10。在一实施例中,一凸轮84定位在供应装置内,并包括一附连到供应装置80的端部的远端和一位于展开器7处的近端。在一实施例中,凸轮84定位在第二轴82内,并轴向地移动通过供应装置80。
凸轮84的运动示于图18和19中。在关闭定向中,供应装置80附连到间隔件10,使凸轮84处于一第一位置,而第三部件40定位在间隔件10的近端。凸轮84在供应装置80内沿轴向移动,以便朝向间隔件10的远端移动第三部件40。凸轮84的一远端接触第三部件40的一近端,以推动第三部件40和展开间隔件10。凸轮84的轴向运动量控制间隔件的展开量。凸轮84从第一定向到第二定向的轴向运动致使第三部件40相对于第一部件20移动,从而导致倾斜部分接触和增加间隔件的高度。凸轮84可操作地连接到第三部件40,这意味着它可附连到第三部件40,或不附连但放置成在致动过程中与第三部件40接触。
图22示出第三部件40的另一实施例。该实施例类似于先前图4所示的实施例,只在近端上添加一突耳140。突耳140包括一接触表面142,在展开过程中,该接触表面接触凸轮84的远端。图23示出凸轮84的另一实施例,该凸轮84具有一接触接触表面142的远端185。在一实施例中,远端185基本上垂直于侧边缘。接触表面142和远端185的形状应这样形成:在展开过程中,形成在两个表面之间的接触角E应保持尽可能地小。此外,在展开过程中,远端185和接触表面142之间的接触量更大。凸轮84可具有各种构造,包括沿着供应装置80的全部或一部分延伸的推杆,并包括接触间隔件的远端185以将其展开到扩展的尺寸。
在一具有仅第一和第二部件(即,没有第三部件)的实施例中,第一部件具有倾斜的表面,它们接触具有倾斜表面的一第二部件。凸轮84定位成接触第一或第二部件之一并提供相对运动以便展开。
图6和7示出由凸轮84造成的第三部件40的运动。在一实施例中,第三部件40近端地定位在间隔件10内,如图6所示。凸轮84的运动朝向远端地移动第三部件40,如图7所示,以致使间隔件10展开。减小间隔件10的一种方式是近端地移动凸轮84并拉第三部件40。
图1示出供应装置80和展开器7的一实施例。各种类型的展开器可应用到供应装置80来扩展间隔件10。展开器可邻近间隔件10定位,或远离间隔件10定位而置于病人体外。在此前提交的美国专利申请No.10/178,960中揭示了各种展开器和朝向打开定向展开间隔件的结构,该专利申请于2002年6月25日提交,其题为“最小创伤的扩展间隔件及其方法”,该专利受让于本申请的同一实体,本文援引其全部内容以供参考。
在一实施例中,展开器7附连到供应装置80的近端。展开器7附连到一锁定装置89,锁定装置又附连到凸轮84。展开器7提供凸轮84通过供应装置80的轴向运动。在一实施例中,旋钮302包括一与接触部件相连的螺纹连接部分。旋钮的转动致使接触部件相对于旋钮302向外移动。当展开器7安装在供应装置80上时,接触部件邻接抵靠锁定装置89的近端。旋钮302的转动致使接触部件沿轴向移动锁定装置89和凸轮84。
在一实施例中,凸轮84的轴向运动量受到控制。图20示出一带有定位在离轴82一轴向距离的锁定装置89的实施例(即,图20示出处于缩回位置的凸轮84)。展开器7的运动致使锁定装置89和凸轮84相对于轴82沿轴向移动。由于锁定装置89的远端接触轴82的近端边缘,所以限制了运动量。可以采用各种其它类型的展开机构来沿轴向移动凸轮84和展开间隔件10。
供应装置80可以各种不同的方式附连到间隔件10。在一实施例中,间隔件10通过延伸通过孔37的可移动的活动枢轴90进行连接。活动枢轴90将间隔件10连接到供应装置80。在脱卸的定向中,活动枢轴90在孔57下方移动,而供应装置80从间隔件10中拆下。一实施例示于图21中。凸轮84延伸通过供应装置80并具有一延伸的结构,其第一尺寸大于第二尺寸。枢轴90邻近凸轮84定位。在附连的定向中,凸轮84的定向使较大的尺寸对齐于枢轴90。枢轴90接触凸轮84并向外延伸通过孔57。在脱卸的定向中,凸轮84转动使较小的尺寸接触枢轴90。枢轴90缩回而顶部边缘99移离孔37。在一实施例中,凸轮84构造成其较大和较小尺寸分离约90°(即,凸轮84约90°的转动导致在附连和脱开定向之间的运动)。在一实施例中,枢轴90包括一圆形表面99以便于间隔件10脱离。在一实施例中,凸轮84在间隔件10从供应装置80中脱开之前先缩回。附连、供应和展开装置的实施例和方法揭示在此前提交的美国专利申请No.10/202,918中,该专利申请于2002年7月25日提交,其题为“用于插入移植物的最小创伤的器械及其方法”,该专利受让于本申请的同一实体,本文援引其全部内容以供参考。
在一实施例中,凸轮84延伸通过供应装置80的一部分并朝向供应装置80的近端进入。一使用装置9的外科医生从病人体外的一点处转动凸轮84,以便从供应装置80中脱开间隔件10。一实施例示于图20中,其中,凸轮84延伸通过轴82并附连到锁定装置89。转动锁定装置89从而致使凸轮84转动,锁定装置89固定地附连到凸轮84。轴82的一近端和锁定装置89的一远端具有对应的指形物113,它们控制凸轮的转动量。锁定装置89相对于轴82的转动被限制在一预定的范围内,因为指形物113将接触和防止其进一步转动。在一实施例中,指形物113定位成将转动限制在约90°。此前提交的美国专利申请No.10/178,960揭示了若干个不同类型的供应装置和控制间隔件的结构,该专利已经被全文援引以供参考。
图24和25示出从供应装置80中脱开间隔件10的拆卸装置的另一实施例。供应装置80包括一在其远端处带有一管套筒150的驱动套筒149。一具有一预定宽度的可释放的套筒153可滑动地定位在管套筒150上。一推杆184在管套筒150内延伸,并包括一展开间隔件10的远端185。延伸部151朝向管套筒150的远端定位并安装在保持器155的孔157内和间隔件10的孔37内。由于间隔件10连接到供应装置80,所以间隔件10围绕延伸部151枢转。一连接件154在保持器155和驱动套筒149之间延伸。驱动套筒149相对于管套筒150的相对运动致使间隔件枢转。
如图26所示,管套筒150包括一具有一个或两个斜坡表面152的远端。斜坡表面152沿着管套筒150逐渐地增加到邻近延伸部151的一点处的一最大高度。一槽159形成在斜坡表面152之间的管套筒150的远端上。槽159在延伸部151安装在间隔件10上时具有一宽度w。
可释放的套筒153可滑动地安装在管套筒150上。可释放的套筒153具有一预定的宽度,其大于管套筒150远离斜坡表面152的一第一部分158的宽度,但小于斜坡表面152的宽度。
图27和28示出供应装置80从间隔件10中脱离的情形。在图27中,当延伸部151定位通过保持器155和间隔件10时,间隔件10连接到供应装置80。可释放的套筒153定位成远离管套筒152的第一部分158上的延伸部。图28示出间隔件10从供应装置80脱离。可释放的套筒153沿着管套筒150的斜坡表面152依照箭头x的方向朝向远端移动。这导致斜坡表面152被迫向内,因此减小宽度w。安装在管套筒150的远端的延伸部151同样地强制向内并从间隔件10中拆下。此时,间隔件10可从供应装置80中移去。保持器155仍保持附连在供应装置80并被移去,仅间隔件10留在病人体内。
在一实施例中,推杆184延伸通过管套筒150内的槽159并防止间隔件10脱离。当推杆184处在槽159内时,防止斜坡表面152强制靠在一起,因此,延伸部151保持在间隔件10内。一旦推杆184被移去(即,沿“-x”方向移动),则斜坡表面152可强制地靠在一起,使宽度w减小从而从间隔件10中移去延伸部151。在另一实施例中,推杆184和斜坡表面之间有足够的间隙以允许减小开口159的宽度w和拆下间隔件。在一实施例中,附件可从可释放的套筒153朝向供应装置80的近端延伸,从而允许外科医生从远处位置释放间隔件10。
在另一实施例中,供应装置80可通过一可剪切的销附连到间隔件10,该可剪切的销设计成:一旦间隔件10展开,则销失效。一旦销剪断,供应装置80可从间隔件10中移去。在另一实施例中,供应装置80通过螺纹附连到间隔件10。供应装置80相对于间隔件10的转动致使间隔件从供应装置80中脱位。在另一实施例中,供应装置80和间隔件10装备有一半圈的锁定系统,这样,供应装置80相对于间隔件10的转动导致发生脱位。
供应装置80可保持附连到间隔件10或可在使用过程中从间隔件中拆下。由于如果留下供应装置80附连在间隔件10上,则其可能与其它设备相干扰,或干扰视线,所以,在手术过程中为了对外科医生提供额外的操作空间,转动供应装置80是必要的。在此使用过程中,供应装置80还可再次附连到间隔件10,以便在手术结束时从病人体内移去。在其它的使用过程中,供应装置80被移去,而间隔件10永久地保持在病人体内。
在一实施例中,凸轮84延伸通过轴82并包括一安装在锁定机构89上的近端。在一实施例中,凸轮84不连接到一锁定装置。在一实施例中,凸轮84可沿轴向移动并可在轴82内转动。在一实施例中,第二轴82安装在第一轴81内。在一实施例中,第一轴81的尺寸做成沿第二轴82的外部滑动。在一实施例中,在铰接和展开过程中第二轴82沿轴向静止不动。在一实施例中,部件200在铰接过程中静止不动。
术语脊椎件一般地用来描述包括脊椎体、蒂、薄片的脊椎几何形以及脊椎处理。间隔件10可以进行尺寸和形状设计,并可具有足够的强度要求以用于不同的脊椎区域内,包括颈椎骨、胸椎骨以及腰椎骨等区域。在一实施例中,间隔件10可具有约20001bf的承载能力。
间隔件可定位在相邻脊椎之间的盘空间内。接触表面21、31接触脊椎的端板以便按需要间隔开脊椎骨。间隔件10可以后部地、前部地或侧部地插入病人体内。
接触表面21、31可以多孔以允许骨质生长进入间隔件10内。一个或两个接触表面21、31可包括一个或多个孔。骨生长材料定位在孔内以容纳骨质生长通过全部的植入物。骨生长材料可包括一海绵、基质,和/或其它浸渍蛋白质的载体,例如,骨成形素蛋白质(BMP)、LIM矿化蛋白质(LMP)等。
在一实施例中,使用一对杠杆来展开间隔件10。在一实施例中,用一具有类似于剪刀那样的一对偏移臂的器械来展开间隔件。
在不脱离本发明的范围和基本特征的前提下,可采用不同于本文所阐述的其它特定方法来实施本发明。在一实施例中,间隔件10和供应装置80可由不锈钢构造。在一实施例中,支承部分定位在倾斜表面的远处。在一实施例中,凸轮184、84是一推杆。在一实施例中,偏置部件108是一盘簧。在一实施例中,当间隔件10处于打开定向时,诸部件的倾斜表面彼此接触。在一实施例中,第二部件30不包括侧壁33,而第三部件40具有的一宽度小于或等于第二部件30的宽度。在一实施例中,间隔件10由钛构造。在一实施例中,间隔件内的孔37的直径约为3.5mm。因此,本发明的诸实施例在各个方面都应认为是示例性的并无限制意义,本发明意将所有落入附后权利要求书的含义和等价范围内的变化都包括在范围之内。
Claims (13)
1.一用来间隔脊椎件的装置,包括:
第一部件和第二部件,各具有一外侧和一内侧,内侧具有的斜坡表面相对于外侧定位成一角度;
一连接到第一和第二部件中的至少一个上的供应装置,具有一细长形状,以便将装置定位在脊椎件之间;以及
一展开器,可操作地连接到第一和第二部件中的一个上,以使第一部件相对于第二部件在斜坡表面脱开的一第一位置和斜坡表面接合的一第二位置之间运动,在诸外侧之间测得的高度在第二位置时大于第一位置时。
2.如权利要求1所述的装置,其特征在于,供应装置可枢转地附连到第一和第二部件中的至少一个上,以便调整第一和第二部件相对于供应装置的角度。
3.如权利要求2所述的装置,其特征在于,供应装置还包括可在一连接位置和一未连接位置之间移动的活动枢轴,在所述连接位置,活动枢轴从供应装置向外延伸以连接到第一和第二部件中的至少一个上,而在所述未连接位置,活动枢轴缩回在供应装置内,以从供应装置中移去第一和第二部件。
4.一间隔脊椎件的装置,包括:
一间隔件,具有一带有第一斜坡的第一部分和一带有第二斜坡的第二部分,间隔件定位在一关闭定向和一打开定向之间;
一细长的供应装置,安装在间隔件上,并具有一附连到第一部分的第一轴和一可操作地连接到第二部分的第二轴,第二轴相对于第一轴可移动,这样,所述细长的供应装置的远端接触第二斜坡,以将第二斜坡从第一斜坡与第二斜坡脱开的关闭定向移动到第一斜坡与第二斜坡接触的打开定向,该间隔件具有的宽度在打开定向时大于关闭定向时。
5.如权利要求4所述的装置,其特征在于,第二轴定位在第一轴内。
6.如权利要求4所述的装置,其特征在于,第二斜坡还包括一具有一接触表面的突耳,该接触表面与第二轴的远端接触。
7.如权利要求4所述的装置,其特征在于,第一轴包括向外延伸的延伸部,它们安装在第一斜坡内的诸孔内。
8.如权利要求7所述的装置,其特征在于,还包括用来从诸孔中脱开延伸部的装置,以将间隔件从供应装置中移去。
9.一间隔脊椎件的装置,包括:
一间隔件,具有一带有第一斜坡的第一部分和一带有第二斜坡的第二部分,间隔件定位在第一斜坡与第二斜坡脱开的一关闭定向和第一斜坡与第二斜坡接触的一打开定向之间,使间隔件的宽度在打开定向时大于关闭定向时,该间隔件还包括一孔;以及
一细长的供应装置,附连在间隔件上,并具有诸延伸部,延伸部可定位在第一位置和第二位置之间移动,在第一位置中,它们从供应装置向外延伸并安装在孔内,而在第二位置中,它们向内缩回并从孔中拆下。
10.如权利要求9所述的装置,其特征在于,供应装置包括一对面向外的斜坡表面,并在第一位置中间隔开一第一距离,以及一可释放的套筒,可移动地定位在供应装置上并具有一高度小于第一距离。
11.如权利要求10所述的装置,其特征在于,诸延伸部定位在供应装置的远端和斜坡表面之间。
12.如权利要求11所述的装置,其特征在于,还包括一推杆,定位在诸斜坡表面之间并可沿供应装置轴向地移动。
13.一间隔脊椎件的装置,包括:
一作用部件,具有一外作用侧和一内作用侧,内作用侧具有一相对于外作用侧倾斜的作用斜坡;
一第二部件,具有一内支承侧和一外第二侧;
一展开部件,定位在作用部件和第二部件之间,展开部件具有一面向作用部件的第一展开侧,以及一与第二部件的内支承侧接触的接触侧,第一展开侧具有一相对于接触侧倾斜的展开斜坡;
一供应装置,具有一细长形状,其第一端可枢转地连接到展开部件,以便相对于供应装置调整展开部件的角度位置,
一轴,沿供应装置可轴向地移动并可操作地连接到展开部件,该轴可在一第一定向和一第二定向之间移动,在第一定向定位展开部件,使展开斜坡与作用斜坡脱开,而在第二定向使展开斜坡与作用斜坡接合。
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2004
- 2004-01-22 US US10/763,115 patent/US7828849B2/en active Active
- 2004-01-30 AT AT04706971T patent/ATE459308T1/de not_active IP Right Cessation
- 2004-01-30 DE DE602004025793T patent/DE602004025793D1/de not_active Expired - Lifetime
- 2004-01-30 EP EP04706971A patent/EP1596764B1/en not_active Expired - Lifetime
- 2004-01-30 CN CN200480006058A patent/CN100594854C/zh not_active Expired - Lifetime
- 2004-01-30 EP EP08168665.1A patent/EP2016924B1/en not_active Expired - Lifetime
- 2004-01-30 JP JP2006503188A patent/JP4485517B2/ja not_active Expired - Fee Related
- 2004-01-30 AU AU2004209913A patent/AU2004209913B2/en not_active Ceased
- 2004-01-30 CA CA002514973A patent/CA2514973A1/en not_active Abandoned
- 2004-01-30 WO PCT/US2004/002666 patent/WO2004069033A2/en active Application Filing
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2010
- 2010-11-05 US US12/940,415 patent/US8579981B2/en active Active
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- 2013-09-24 US US14/034,811 patent/US8986389B2/en not_active Expired - Lifetime
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- 2016-01-29 US US15/010,556 patent/US9750617B2/en not_active Expired - Lifetime
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US20160143748A1 (en) | 2016-05-26 |
US20040153065A1 (en) | 2004-08-05 |
EP2016924A2 (en) | 2009-01-21 |
EP2016924A3 (en) | 2009-04-08 |
AU2004209913B2 (en) | 2009-11-12 |
US20140025170A1 (en) | 2014-01-23 |
EP1596764B1 (en) | 2010-03-03 |
US8986389B2 (en) | 2015-03-24 |
EP1596764A2 (en) | 2005-11-23 |
JP4485517B2 (ja) | 2010-06-23 |
ATE459308T1 (de) | 2010-03-15 |
CA2514973A1 (en) | 2004-08-19 |
AU2004209913A1 (en) | 2004-08-19 |
US20170333206A1 (en) | 2017-11-23 |
US20150150691A1 (en) | 2015-06-04 |
US20110054621A1 (en) | 2011-03-03 |
US10265191B2 (en) | 2019-04-23 |
JP2006516456A (ja) | 2006-07-06 |
US7828849B2 (en) | 2010-11-09 |
WO2004069033A2 (en) | 2004-08-19 |
EP2016924B1 (en) | 2017-03-15 |
DE602004025793D1 (de) | 2010-04-15 |
WO2004069033A3 (en) | 2005-01-27 |
US9271846B2 (en) | 2016-03-01 |
US8579981B2 (en) | 2013-11-12 |
US9750617B2 (en) | 2017-09-05 |
CN1756516A (zh) | 2006-04-05 |
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