CN101180001A - 脊柱运动节段后路动态稳定的植入物和方法 - Google Patents

脊柱运动节段后路动态稳定的植入物和方法 Download PDF

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CN101180001A
CN101180001A CNA2006800175813A CN200680017581A CN101180001A CN 101180001 A CN101180001 A CN 101180001A CN A2006800175813 A CNA2006800175813 A CN A2006800175813A CN 200680017581 A CN200680017581 A CN 200680017581A CN 101180001 A CN101180001 A CN 101180001A
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M·M·莫里森
A·布鲁钮
J·M·德威利
T·A·卡利斯
E·C·朗恩
K·M·安德森
F·J·莫利兹四世
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Warsaw Orthopedic Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • 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 ; Bone 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, e.g. tourniquets
    • 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, setting implements or the like
    • 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 ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • 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

Abstract

一种用于稳定脊柱运动节段的植入物组件(30、130、132、230)，其包括可在相邻棘突间定位的间隔件(32)以及从所述间隔件(32)延伸的上下啮合元件(50、150、250、70、170、270)。所述上下啮合元件(50、150、250、70、170、270)啮合至少一个椎板以抵抗脊柱运动节段的屈曲运动。

Description

脊柱运动节段后路动态稳定的植入物和方法
背景技术
植入物可定位在相邻棘突之间，从而耐受脊柱伸展导致的椎骨运动。这些植入物用作动态限制脊柱伸展的震动吸收器或缓冲器。植入物可通过完全围绕棘突和植入物延伸的环状索或带固定于相邻棘突，以保持植入物定位在棘突之间同时限制脊柱屈曲。然而，这些环状索或带一旦受到足够的力，将沿各个棘突的上表面或下表面锲入骨。而且，环状索或带在棘突之间的位置将暴露于椎孔，潜在地进入或侵入椎孔。
发明概述
提供了一种脊柱植入物组件，其包括可在相邻棘突间定位的间隔件，两端分别接触脊突之一以限制脊柱运动节段的伸展；以及联结于脊柱运动节段的啮合元件以限制屈曲运动。啮合元件中至少一个被构造成接触与间隔件末端接触的棘突表面相对侧的椎板表面。
根据一方面，脊柱植入物组件包括：在脊柱运动节段相邻的上下棘突间定位的第一和第二相对端间延伸的间隔件。所述间隔件包括一可压缩主体，以动态限制上下棘突在脊柱运动节段伸展时的相互靠近运动。上啮合元件和下啮合元件各自从间隔件延伸并与脊柱运动节段啮合以限制脊柱运动节段的屈曲运动。所述上下啮合元件中至少一个被构造成能够沿上下棘突之一附近的椎板表面定位。所述椎板表面在与相邻的间隔件第一和第二端之一接触的各个棘突表面的相对侧。
另一方面，脊柱植入物组件包括：在脊柱运动节段相邻的上下棘突间定位的第一和第二相对端间延伸的间隔件。所述间隔件包括一可压缩主体，以动态限制上下棘突在脊柱运动节段伸展时的相互靠近运动。上啮合元件和下啮合元件分别从间隔件的第一和第二端延伸。所述上啮合元件包括沿靠近上棘突的上椎板的上表面定位的钩状末端部分，所述下啮合元件包括沿下棘突下表面定位的钩状末端部分。所述啮合元件接触各个椎板表面以限制脊柱运动节段的屈曲运动。
又一方面，一种稳定脊柱运动节段的方法，该方法包括：使间隔件定位在脊柱运动节段相邻的上下棘突之间，所述间隔件包括接触上棘突下表面的上端和接触下棘突上表面的下端；使从间隔件上端延伸的上啮合元件接触上棘突附近上椎板的上表面定位；和使从间隔件下端延伸的下啮合元件接触下棘突附近向下取向的表面定位。
根据又一方面，脊柱植入物组件包括可在脊柱运动节段相邻的上下棘突间定位的第一和第二相对端间延伸的间隔件。所述第一和第二端各自包括沿所述相邻棘突两侧延伸的一对臂。所述间隔件包括一可压缩主体，以动态限制所述上下棘突在脊柱运动节段伸展时的相互靠近运动。组件还包括第一啮合元件和第二啮合元件，它们各自从间隔件延伸并可啮合脊柱运动节段以限制脊柱运动节段的屈曲运动。所述第一啮合元件在第一端沿一个臂与间隔件啮合，所述第二啮合元件在第二端沿一个臂与间隔件啮合。
下面将进一步描述这些和其它方面。
附图简要说明
图1是啮合有植入物组件的脊柱运动节段后部的立体图。
图2是图1所示脊柱运动节段的部分放大图，显示了植入物组件的啮合元件和椎板。
图3是另一个实施方式的脊柱运动节段后部元件之间的植入物组件的正视图。
图4是另一个实施方式的脊柱运动节段后部元件之间的植入物组件的正视图。
图5是另一个实施方式的植入物组件的正视图。
具体实施方式
为了促进对本发明原理的理解，现在将参考本文所示实施方式并用附图和具体的语言来描述这些实施方式。但是应理解，这不是对本发明范围的限制，考虑了所述装置的任何改变和进一步改进，以及本文所述本发明原理的进一步应用，如本发明所属领域技术人员通常所明白的那样。
植入物可定位在脊柱运动节段的相邻棘突之间，从而动态稳定和限制脊柱伸展和屈曲。植入物包括容纳在棘突之间的间隔件，可压缩间隔件以实现运动节段的伸展运动，同时维持棘突间的分离力。植入物还包括从间隔件的各个上端和下端延伸的啮合元件。啮合元件啮合脊柱运动节段以限制屈曲运动。至少一个啮合元件被构造成能够啮合各个棘突附近的椎板表面。椎板提供了稳定的支持表面，该表面适合抵抗植入物对抗运动节段屈曲而施加的负荷。椎板与啮合元件的啮合还降低了后部椎骨元件上的扭转负荷。
在另一个实施方式中，植入物组件的上下啮合元件分别沿各个棘突附近的椎板表面啮合。啮合元件啮合间隔件两端支持的棘突表面对侧的椎板表面。在另一个实施方式中，啮合元件包括钩状末端，上啮合元件的钩状末端沿上椎板上表面延伸，下啮合元件的钩状末端沿下元件下表面延伸。在另一个实施方式中，啮合元件可移动地联结于间隔件。在另一个实施方式中，上下啮合元件中至少一个包括弹性连接部分，该弹性连接部分允许运动节段有限屈曲的同时维持啮合元件与椎板的啮合。
图1显示了一个脊柱节段10，它包括上椎骨11、下椎骨15和其间的椎间盘13。椎骨11、15和椎间盘13构成一脊柱运动节段，应理解，脊柱运动节段可包括多个椎骨水平。上椎骨11包括从上椎骨16延伸的上棘突12。下椎骨15包括从下椎板18延伸的下棘突14。棘突12、14和椎板16、18构成脊柱运动节段的后部椎骨元件。
脊柱植入物组件30的定位能够啮合后部椎骨元件以提供动态脊柱稳定作用。脊柱植入物组件30包括从棘突12、14相邻表面间延伸并接触这两个表面的间隔件32，从而抑制脊柱运动节段伸展导致的棘突相互靠近运动。例如，间隔件32可包括与棘突12的下表面22接触的上端34和与棘突14的上表面26接触的下端36。间隔件32包括一主体，主体被构造成能够响应脊柱运动节段的伸展而弹性压缩，由于间隔件32的压缩来抵抗伸展力和限制棘突12、14相互靠近运动。
植入物组件30包括从间隔件32延伸的上啮合元件50和下啮合元件70。上啮合元件50沿上椎板16的上表面20延伸并接触该表面，下啮合元件70沿下椎板18的下表面24延伸并接触该表面。因此，啮合元件50、70能够限制运动节段屈曲导致的棘突12、14相互远离运动。在一个实施方式中，啮合元件50、70可移动地联结间隔件32以便于操纵啮合元件50、70和放置到脊柱椎板上。例如，如图2所示，啮合元件50包括从间隔件32延伸的连接部分54和沿椎板16上表面定位的钩状末端部分52。钩状末端部分52与脊柱椎板的啮合提供了骨性支持面，该表面的大小和强度足以抵抗啮合元件50、70产生的力而不会使骨胳发生破裂、断裂或不恰当的变形。
为了便于啮合元件50、70分别沿椎板16、18的定位，啮合元件50、70可朝间隔件32的前侧38偏移。间隔件32的后侧40在棘突12、14间向后取向。由于末端34、36分别啮合棘突12、14的相邻表面，沿前侧38定位啮合元件50、70有利于与各个椎板16、18的啮合，椎板16、18各自位于相邻棘突12、14的前方。
在一个实施方式中，啮合元件50包括柔性连接部分54和刚性钩状末端部分52。柔性连接部分54有利于操纵啮合元件50靠近间隔件32并定位成与椎板啮合。在一个实施方式中，连接部分54包括弹簧样结构，该结构可弹性伸展或拉长成沿上椎板表面定位钩状末端部分，连接部分54弹性回到其伸展前状态以使钩状末端部分52偏置成与椎板16上表面啮合的位置。啮合元件70的构造可与啮合元件50相同以啮合下椎板18的下表面。在另一个实施方式中，啮合元件50、70其中之一包括弹簧样连接部分，该部分可拉长而其它部分不行。在另一种形式中，啮合元件50、70各自为刚性。
连接部分54可以任何合适的方式联结于间隔件32。在一个实施方式中，连接部分54可移动地联结于间隔件32。连接部分54可与间隔件32一体成形，或者可通过紧固件、缝线、锚件、索缆、连杆、包覆成型或其它合适的连接方式附连。间隔件32可具有突起、眼孔、凹陷或其它合适的结构以便啮合元件50与间隔件32的啮合。连接部分74的构型类似。
现在参考图3，显示了脊柱植入物组件130，它具有间隔件32和联结于间隔件32两端的啮合元件150、170。间隔件32包括第一对上臂42和第二对下臂44，上臂42间延伸形成凹面上表面34以套叠接纳棘突12，下臂44间延伸形成凹面下表面36以套叠接纳棘突14。臂42、44分别沿棘突12、14的两侧延伸，防止间隔件32从棘突12、14间侧向滑出或脱位。
植入物组件130包括上啮合元件150和下啮合元件170，它们以与上文植入物组件30中所述相同或相似的方式啮合上椎板16和下椎板18。啮合元件150包括钩状末端部分152和沿上臂42之一延伸定位的连接部分154。类似地，啮合元件170包括钩状末端部分172和沿下臂44之一延伸定位的连接部分174。啮合臂150的末端156沿臂42定位，使得在其植入位置中，啮合元件150不沿沿脊柱运动节段延伸的椎孔定位。例如，臂42上端离开椎孔解剖学开口的距离为184，而啮合元件150的末端156离开臂42上端的距离为182，使其在上方或头侧离开通往椎孔的椎骨间的开口。臂170的末端176相对于下臂44之一类似定位。其它实施方式考虑，啮合元件和连接元件中的一个或多个沿椎孔延伸并暴露于椎孔的布置。
连接元件180延伸穿过间隔件32，由围绕连接元件180的间隔件32的主体与椎孔隔离。连接元件180的两端分别联结于啮合元件150、170的各个末端156、176，以使啮合元件150、170固定于间隔件32，同时允许啮合元件150、170相对于间隔件32枢转运动。
现在参考图4，显示了另一个实施方式的植入物组件132。植入物组件132类似于上述植入物组件130，类似的元件用类似的附图标记表示。然而，啮合元件150相对于啮合元件170在中轴线133的相对侧上相对于间隔件32定位，而在图3中，啮合元件150和啮合元件170在轴线133的同侧定位。在图4中，连接元件190经轴线穿过间隔件32延伸，联结于啮合元件150、170的末端156、176。
在图3和4所示实施方式中，连接部分154、174可以是刚性，虽然考虑了柔性连接部分154、174。末端156、176可通过销、紧固件、摩擦匹配、粘合剂、融合、卷边或其它合适的连接方式联结于连接元件180、190。末端156、176分别沿臂42、44定位，使其定位和运动避开椎孔。
在图5中，显示了另一种植入物组件230，它包括间隔件32以及延伸穿过其中的连接元件280。连接元件280包括上端254，上端254从臂42一侧延伸至啮合元件250的钩状末端部分252。连接元件280在连接处256联结于钩状末端部分252。连接处256可包括销、紧固件、摩擦匹配、粘合剂、融合、卷边或其它合适的联结方式。连接元件280还包括下端274，下端274从臂44的一侧延伸至啮合元件270的钩状末端部分272。连接元件280在连接处276联结于钩状末端部分272。连接处276可包括销、紧固件、摩擦匹配、粘合剂、融合、卷边或其它合适的联结方式。啮合元件250、270可在主体中轴线的同侧定位，或者可在中轴线的对侧定位。
连接元件280从间隔件32的主体延伸，使其与各个上下啮合元件250、270的连接与间隔件32隔开。连接元件280在两个啮合元件250、270间柔性延伸以允许啮合元件250、270的运动。连接元件280还可伸展但具有弹性以提供弹簧样联结方式，有助于维持啮合元件250、270的钩状末端部分分别与椎板表面的接触。而且，钩状末端部分250、270各自包括一接触表面251、271，其表面特征有利于与椎板的啮合。这些表面特征包括销钉、齿、粗糙化、滚花、表面处理、蚀刻、紧固件或其它中断件以便使啮合元件相对于椎板表面的啮合增强和抵抗其间的运动。其它啮合元件的实施方式也可具有表面特征。
在采用连接元件的植入物组件实施方式中，连接元件延伸穿过间隔件32的主体，使其在植入后不会暴露于间隔件32外部和邻近的解剖学结构。这种设置避免了例如连接元件暴露于椎孔和神经组织。连接元件与啮合元件在沿各个臂42、44位置的连接也避免了暴露于椎孔。连接元件可穿过间隔件中形成的一个或多个通道定位，或者间隔件可围绕连接元件包覆成型。考虑了各种形式的连接元件，包括例如索缆、线、缝线、绳索、带、带状物、刚性连接或杆、柔性连接或杆。
在本文所述的各个实施方式中，可采用各种装置和/或技术将啮合元件连接或固定于间隔件，或者啮合元件可与间隔件一体成形或形成间隔件的延伸部。间隔件可通过(例如)啮合元件与间隔件的缝合、热焊接或粘结、粘合剂粘结、三维织造或编织、螺钉、卡钉、销钉、定位焊或铆钉固定等方式连接或附连于啮合元件。而且，啮合元件可在间隔件定位于棘突间的之前或之后固定于间隔件。
间隔件可由柔性或至少显示部分柔性的部件构成。这些部件的例子包括：机织管状织物、机织和非机织织网、或编织或机织结构、缝线、系绳、绳索、平面元件、带、线、索或能够在相邻棘突间延伸并支持相邻棘突的任何其它元件。此外，间隔件可以是弹性和/或伸缩的，从而配合插入和附连期间的各种形状。
间隔件可由任何生物相容的材料构成，合成或天然来源的材料、重吸收性或非重吸收性材料构成。间隔件材料合适的例子包括：自体移植物、同种异体移植物或异种移植物；组织材料，包括软组织、结缔组织、脱矿骨基质及其组合；重吸收性材料，包括聚丙交酯、聚乙交酯、酪氨酸-衍生的聚碳酸酯、聚酐、聚原酸酯、聚膦腈、磷酸钙、羟基磷灰石、生物活性玻璃、胶原、白蛋白、纤维蛋白原及其组合；以及非重吸收性材料，包括聚乙烯、聚酯、聚乙烯醇、聚丙烯腈、聚酰胺、聚四氟乙烯、聚对苯二甲酸对苯二酯、聚醚醚酮、纤维素及其组合。
本文所述啮合元件可由以下生物相容材料中的任一种或其组合构成，包括合成或天然自体移植组织、同种异体移植组织、异体移植组织，并且可以是重吸收性或非重吸收性的。组织材料的例子包括硬组织、结缔组织、脱矿骨基质及其组合。重吸收性材料的进一步例子包括聚丙交酯、聚乙交酯、酪氨酸衍生的聚碳酸酯、聚酐、聚原酸酯、聚膦腈、磷酸钙、羟基磷灰石、生物活性玻璃及其组合。非重吸收性材料的进一步例子包括碳强化聚合物复合材料、形状记忆合金、钛、钛合金、钴铬合金、不锈钢及其组合。
在一个实施方式中，钩状末端部分为刚性，由金属材料、聚合物材料或其它显示刚性的材料构成，连接部分为柔性以便啮合元件沿椎板的定位。在另一个实施方式中，连接部分具有弹性，由能够伸展的弹簧或弹簧样材料构成，便于钩状末端部分沿椎板的定位和回弹到维持钩状末端部分与相应的椎板表面的接触。
虽然在附图和上述说明中详细阐述和描述了本发明，认为这些描述是示例性而非限制性的。本发明精神范围内的所有改变和改进都需要保护。

Claims (27)

1.一种脊柱植入物组件，其包括：
定位于脊柱运动节段相邻的上下棘突之间的在第一和第二相对端间延伸的间隔件，所述间隔件包括可压缩主体，以动态限制上下棘突在脊柱运动节段伸展时的相互靠近运动；和
上啮合元件和下啮合元件，它们分别从间隔件延伸并与脊柱运动节段可啮合以限制脊柱运动节段的屈曲，所述上下啮合元件中至少一个被构造成能够沿上下棘突之一附近的椎板表面定位，所述椎板表面在一个棘突与间隔件的第一和第二端相邻的一端接触的表面的相对侧。
2.如权利要求1所述的组件，其特征在于，所述上下啮合元件中的另一个被构造成能够沿另一个棘突附近的椎板表面定位，所述另一椎板表面在另一个棘突与间隔件的第一和第二端中另一端接触的表面的相对侧。
3.如权利要求1所述的组件，其特征在于，所述间隔件包括在其第一端的第一对臂和在其第二端的第二对臂，所述各对臂在其间各自形成凹面，用于在其中接纳相邻的上下棘突，所述各对臂的各个臂沿相邻棘突的相对侧延伸。
4.如权利要求3所述的组件，其特征在于，所述上啮合元件包括在所述第一端处啮合于所述臂之一处的所述间隔件的连接部分，所述下啮合元件包括在所述第二端处啮合于所述臂之一处的所述间隔件的连接部分。
5.如权利要求4所述的组件，其特征在于，所述组件还包括延伸穿过所述间隔件并连接于所述上下啮元件的所述连接部分的连接元件。
6.如权利要求4所述的组件，其特征在于，所述上下啮合元件位于在所述间隔件的所述第一和第二端间延伸的中轴线的两侧。
7.如权利要求4所述的组件，其特征在于，所述上下啮合元件位于在所述间隔件的所述第一和第二端间延伸的中轴线的同侧。
8.如权利要求4所述的组件，其特征在于，所述上下啮合元件各自的所述连接部分与所述间隔件的各个所述臂枢轴联结。
9.如权利要求1所述的组件，其特征在于，
所述上下啮合元件中至少一个包括接触椎板表面可定位的钩状末端部分；和
所述上下啮合元件中的另一个包括被构造成能够沿另一个棘突附近的第二椎板表面定位的钩状末端部分，所述第二椎板表面在另一个棘突与间隔件的第一和第二端中另一端接触的表面的相对侧。
10.如权利要求9所述的组件，其特征在于，还包括延伸穿过所述间隔件并分别连接于所述上下啮合元件的连接元件。
11.如权利要求10所述的组件，其特征在于，所述上下啮合元件各自包括所述间隔件附近的柔性部分，而所述上下啮合元件各自的所述钩状末端部分为刚性。
12.如权利要求1所述的组件，其特征在于，所述上下啮合元件中至少一个包括沿椎板表面可定位的刚性钩状末端部分，并且还包括从所述钩状末端部分延伸穿过所述间隔件到达所述上下啮合元件中另一个的柔性连接部分。
13.如权利要求12所述的组件，其特征在于，所述钩状末端部分包括便于与椎板表面啮合的表面特征。
14.一种脊柱植入物组件，其包括：
定位于脊柱运动节段相邻的上下棘突之间的在第一和第二相对端间延伸的间隔件，所述间隔件包括可压缩主体，以动态限制上下棘突在脊柱运动节段伸展时的相互靠近运动；和
分别从所述间隔件的第一和第二端延伸的上啮合元件和下啮合元件，所述上啮合元件包括沿上棘突附近上椎板的上表面可定位的钩状末端部分，所述下啮合元件包括沿下棘突的下表面可定位的钩状末端部分，所述啮合元件分别接触椎板表面以限制脊柱运动节段的屈曲。
15.如权利要求14所述的组件，其特征在于，所述间隔件包括在所述第一端的第一对臂和在所述第二端的第二对臂，所述各对臂之间各自形成凹面，用于在其中接纳相邻的上或下棘突，其中，所述各对臂的各个臂分别沿相邻棘突的一侧延伸。
16.如权利要求15所述的组件，其特征在于，所述上啮合元件包括在所述第一端处啮合于邻近所述臂之一的所述间隔件的连接部分，所述下啮合元件包括在所述第二端处啮合于邻近所述臂之一的所述间隔件的连接部分。
17.如权利要求16所述的组件，其特征在于，还包括延伸穿过所述间隔件并连接所述上下啮合元件的所述连接部分的连接元件。
18.如权利要求17所述的组件，其特征在于，所述上下啮合元件位于在所述间隔件的所述第一和第二端间延伸的中轴线的两侧。
19.如权利要求17所述的组件，其特征在于，所述上下啮合元件位于在所述间隔件的所述第一和第二端间延伸的中轴线的同侧。
20.如权利要求16所述的组件，其特征在于，所述啮合元件各自的连接部分与各个相邻臂枢轴联结。
21.一种稳定脊柱运动节段的方法，所述方法包括：
使间隔件定位在脊柱运动节段相邻的上下棘突之间，所述间隔件包括接触上棘突下表面的上端和接触下棘突上表面的下端；
使从间隔件上端延伸的上啮合元件接触上棘突附近上椎板的上表面定位；和
使从间隔件下端延伸的下啮合元件接触下棘突附近向下取向的表面定位。
22.如权利要求21所述的方法，其特征在于，所述向下取向的表面沿下棘突附近的下椎板延伸，所述使下啮合元件定位的步骤包括使下椎板的下表面与下啮合元件接触。
23.如权利要求22所述的方法，其特征在于，所述使上啮合元件和下啮合元件定位的步骤分别包括使钩状末端部分接触各个椎板表面定位。
24.如权利要求21所述的方法，其特征在于，所述方法还包括在使上啮合元件接触上椎板的上表面定位之前弹性伸展上啮合元件的步骤。
25.如权利要求21所述的方法，其特征在于，当间隔件在上下棘突间定位时，所述上下啮合元件分别沿各个上下棘突与间隔件可移动地联结。
26.一种脊柱植入物组件，包括：
定位于脊柱运动节段相邻的上下棘突之间的在第一和第二相对端间延伸的间隔件，所述第一和第二端各自包括沿所述相邻棘突两侧延伸的一对臂，所述间隔件包括可压缩主体，以动态限制所述上下棘突在脊柱运动节段伸展时的相互靠近运动；和
第一啮合元件和第二啮合元件，它们各自从间隔件延伸并与脊柱运动节段可啮合以限制脊柱运动节段的屈曲，所述第一啮合元件在所述间隔件的第一端啮合于并终止于所述臂之一，所述第二啮合元件在所述间隔件的第二端啮合于并终止于所述臂之一。
27.如权利要求26所述的组件，其特征在于，所述第一和第二啮合元件分别被构造成接触各个上或下棘突附近的相应椎板表面定位，所述椎板表面在各个上或下棘突与所述各对臂间的所述间隔件接触的表面的相对侧。
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AU2006235096A1 (en) 2006-10-19
RU2007141339A (ru) 2009-05-20
US8034079B2 (en) 2011-10-11
JP2008535626A (ja) 2008-09-04
CA2604208A1 (en) 2006-10-19
KR20080024461A (ko) 2008-03-18
EP1895919A1 (en) 2008-03-12
JP4707738B2 (ja) 2011-06-22
US20060241614A1 (en) 2006-10-26
WO2006110464A1 (en) 2006-10-19

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