DE19738052A1 - Segment insert for ventral side cavity in vertebral column - Google Patents

Abstract

The segment has a trapezoidal cross-section, a relatively wide outer wall in contact with the outer surface of the vertebral column, and cross-direction grooves in opposite end walls. The tubular segment (1) has a trapezoidal cross-section with two parallel outer walls (2, 3), shaped to allow all of the segment to fit tightly inside the vertebral column cavity. The wider outer wall (3) is in contact with the outer surface of the vertebral column. The end walls (6, 7) each contain a groove profile (8, 9) running transverse to the length direction (L) of the segment.

Description

The invention relates to an insert body for insertion into one, in a human's spine tig recess, which consists of an essentially Lichen tubular insert segment formed is.

Such an insert body of the generic type is used for the partial replacement of a tumor-altered vertebra columnar area, especially cervical vertebrae and / or intervertebral discs. For inserting the insert body is by milling out the tumorous area of the spine removed and a corresponding recess on the ventral side in the vertebral body and / or the adjacent intervertebral discs created. The adjacent ones can also be provided Remove all intervertebral discs. In this exception The insert body is inserted on the ventral side and  connected to the rest of the vertebral body so that the tu morally altered cervical vertebrae and / or the spine be at least partially replaced.

So far, are known as tubular insert bodies used segments, for the use of which a large part of the Vertebral body must be removed. These application segments have a circular pipe cross section and are therefore difficult to connect with the rest of the vertebrae to bring. Furthermore, such operational segments only suitable as a replacement for the actual one To serve vertebral bodies, being damaged for example Intervertebral discs through such a tubular insert body can not be supported by or replaced individually.

Accordingly, the invention is based on the object Insert body of the generic type in this way ten that it is variable as an insert body in the field of Spine is applicable and both for replacement or partial replacement of a vertebral body or one Intervertebral disc can be used.

The object is achieved in that the tubular insert segment an approximately trapezoidal Au external cross-section with two parallel to each other Has outer walls, and that the insert segment in the recess of the spine  is suitable and fully usable, and that the porridge tere of the two outer walls with their outer surface in one set state with the outer surface of the spine in the we notably flush and that the front Boundary areas of the insert segment each with a groove profile running transversely to the direction of insertion hen are.

Due to the configuration according to the invention, an on sentence body or an insert segment are available provides for its use in a spine audible recess in the simplest way in a vertebra body or into an intervertebral disc through its trapezoidal shape can be made to suit the outside cross-section. The Insert segment is completely in the recess the spine so that its wider outside wall of the two parallel outside walls are essentially flush with the outside of the spine area closes. Because of this type of insertion the lateral ones, essentially transverse to the parallel ones Outer walls running side walls of the insert segment flat in the recess of the spine, so that at good fit an at least approximately play-free hold the insert segment is accessible in the recess. For a more tight fit in the recess are the frontal boundary surfaces of the insert leg  mentes with a transverse to the direction of insertion Groove profile provided. If a recess is provided in a vertebral body, which extends over the entire length of the vertebral body stretches and forms a kind of continuous groove, they grip Groove profiles in the adjacent intervertebral discs, or at cleared intervertebral discs in the neighboring vertebrae per one. The length of the insert segment is depending depending on the application, according to the length of the vertebra body or the axial distance between the two milled vertebral bodies adapted to adjacent vertebral bodies. In the axial direction there is between the vertebral bodies due to the existing supporting muscles of the spine always an axial contact pressure, which creates the groove profiles a firm hold of the insert segment in its Vertebral recess or between the adjacent ligament Ensure disks or whirling safely. Also at Insert the insert segment into an intervertebral disc, which consists of essentially elastic material an additional through these transverse groove profiles secure hold of the insert segment in the bandschei be guaranteed. The recess in the intervertebral disc is pocket-shaped, in which the one insert segment is inserted on the ventral side.  

According to claims 2 and 3, two are different trained insert segments provided, according to An saying 2 an insert segment for inserting into a we is designed as a vertebral segment. The axial The length of the vertebral segment is approximately the axial length ge of the vertebral body adapted so that this after Use on the neighboring, lead in the spine intervertebral discs over his grooved profiles end faces are firmly supported. As a further variant, according to claim 2, a spinal cord ment provided, the axial length of the distance of the two vertebral bodies is matched, which is the vertebral body by, in which the vertebral segment is arranged, cont are beard. This means that this is in the vertebrae via the inserted vertebral segment over its two grooves profiles firmly attached to the adjacent vertebrae supports sitting. Accordingly, the ventral sei recess in the vertebral body, in which chem the vertebral segment is inserted, as toured above shown, a kind of axially continuous receiving groove, which on the ventral side for the use of the vertebral segment of fen is.

This is tubular for use in an intervertebral disc Insert segment according to claim 3 as an intervertebral disc segment formed and has an axial length which is about the  Corresponds to the thickness of the intervertebral disc. This intervertebral disc On the one hand, ment can replace the band completely slice provided after their complete corpectomy be. The length is as close as possible to the thickness the intervertebral disc or the original intervertebral disc agree to a correspondingly correct vertebral distance ensure. Through the grooved profile of the two foreheads side boundary surfaces of the intervertebral disc segment this becomes stuck between the two adjacent ones Vertebral bodies held, being in the front Be boundary surfaces of the vertebrae each correspond appropriate counter profile to the grooved profiles of the intervertebral disc can be milled to ensure a secure hold to further improve the intervertebral disc segment. The intervertebral disc segment can also be used ment is somewhat shorter in its axial length than the thickness of the remaining intervertebral disc, so that the intervertebral disc segment in a corresponding in the Intervertebral disc inserted ventrally open, pocket-like Recess can be used. Due to the elasticity of the Intervertebral disc material is over the intervertebral disc segment its two grooved profiles on its front end tion surfaces held securely in this recess.

By the configuration according to the invention according to claim 4 is the vertebral segment with at least one intervertebral disc  segment can be combined to form an insert body, the Intervertebral disc segment in the inserted state milled vertebral body adjacent disc completely dig replaced after their previous corpectomy. Through the Can be combined with the vertebral segment and the ligament disc segments are different possible uses the deployment segments ensured, this ent speaking finding of a tumorous spine are adjustable in their axial length.

Other options for setting the different The total length of the spinal segment can be on its forehead side boundary surfaces with one or more ren disc segments according to claim 5 to a full permanent insert body can be combined.

According to claim 6, there is a connection between the we belsegment and the intervertebral disc segment or the band disc segments by a screw connection, so that a firm hold of the intervertebral disc segments at the Wir segment is ensured. It is understood that there in the groove profiles of the intervertebral disc segments and the Vertebral segments are coordinated so that a appropriate fit of the intervertebral disc segments on the vertebra segment is ensured.  

By the configuration according to claim 7 of the obliquely the parallel outer surfaces of the insert segment side walls symmetrical to the median longitudinal plane of the Insert segment is an extremely simple geometry of the Insert body or the insert segment reached. Since that Insert segment with its trapezoidal narrow side in the corresponding recesses in the spine is set and thus has a slight wedge shape, is a simple use and a simple fixation esp especially in the sense of a light tight fit in the out take accessible so that a simple and safe Hal secured in the recess of the spine is.

Through the elongated openings in the sloping side walls of the vertebral segment ge according to claim 8 is an extremely lightweight design as well a secure hold of the vertebral segment in the correspond reached the recess of a vertebral body. After this Insert the vertebral segment into the milled recess The vertebral body can be in the area of the sides walls at least partially in these breakthroughs sen, so that a lifelong secure hold of the spinal cord mentes in the vertebral body.  

Due to the configuration according to claim 9, an additional Licher secure hold of the insert segment in the corresponding Appropriate recess of the spine is reached. It serves an additional holding plate, which for example the adjacent vertebral bodies can be screwed tightly is. This additional holding plate is not mandatory required, but offers especially in the immediate noticeable time after the operational insertion of an set body or insert segment in a vertebral body and / or an intervertebral disc ensuring that the insert segment not involuntarily from its recess can solve.

By using a titanium alloy according to the invention tion according to claim 9 both for the application segment An extremely good biocompa is also used for the holding plate tibility achieved, so that both the application segment as the holding plate can remain in the body for life without causing adverse side effects. As Alloy can be ASTM F 136 or a similar alloy comparable chemical and mechanical egg properties.

Due to the oblique arrangement of the end faces of the insert segment symmetrical to transverse to the longitudinal central axis of the Cross segment plane extending one insert segment  Tilt angle of about 1 ° to 3 ° will adjust to the curved course of the spine in the simplest Way achieved. This adjustment can also be done by Combination of the vertebral segment and one or more Intervertebral disc segments occur because of their combination further different angles of inclination can be set.

Based on the drawing, the invention is in the following ago explained. It shows:

Figure 1 shows an insert segment in the form of a Wirbelsegmen tes in perspective.

Figure 2 shows a second embodiment of a vertebral body in three basic views.

Figure 3 shows another embodiment of a vortex segment of greater length in side view.

Figure 4 shows an insert segment in the form of an intervertebral disc segment in three basic views.

Fig. 5 is a section VV the plan view of Fig. 4;

Fig. 6, an additional support plate in plan view;

Fig. 7 is a partial section VII-VII of Fig. 6;

Figure 8 is a partial section through a spine section with inserted insert body.

FIG. 9 shows a section IX-IX from FIG. 8;

Fig. 10 is a side view of an insert body consisting of a vertebral segment and a disc segment;

Fig. 11 is a plan view of XI of Fig. 10.

Fig. 1 shows an embodiment of a Einsatzsegmen tes, which is designed in the form of a vertebral segment 1 . The vertebral segment 1 is approximately tubular and has an essentially trapezoidal basic cross section or outer cross section. Thus, the vortex segment 1 forms a narrower front outer wall 2 and a wider rear outer wall 3 , which are interconnected by a rear side wall 4 and a front side wall 5 . The front upper boundary surfaces 6 and the front lower boundary surface 7 are each provided with a groove profile 8 and 9 , which extends over the entire width of the associated Be boundary surface 6 and 7 respectively.

Through the two outer walls 2 and 3 and through the side walls 4 and 5 , a continuous bilaterally open channel 10 is formed in the interior of the vertebral segment 1 . The two side walls 4 and 5 each have three long hole-like openings 11 . When the vertebral segment 1 is inserted into a vertebral body, the vertebral body can at least partially grow into these openings 11 , so that a secure hold of the vertebral segment 1 in the vertebral body can be achieved.

The vertebral segment 1 can be inserted into this recess in the direction of insertion of the arrow 12 for insertion into a correspondingly shaped recess which is introduced on the ventral side into a vertebral body of a human spine. Thus, the vertebral segment 1 lies in the inserted state with its narrower front outer wall 2 inside the recess of the vertebral body. Since the recess of the vertebral body is designed such that the vertebral segment 1 with its wider rear outer wall 3 is approximately flush with the outer vertebral column or with the outer surface of the vertebral body. In the upper boundary surface 6 and in the lower boundary surface 7 , two screw threads 13 and 14 are provided in the region of the wider outer wall 3 , which, as described further below, serve for combination with another insert segment.

Fig. 2 shows a second embodiment of a We belsegmentes 15 , which is designed in its basic form in wesentli Chen the same as the vertebral segment. 1 The vertebral segment 15 differs from the vertebral segment 1 from FIG. 1 essentially by its greater overall axial length L. Furthermore, the exemplary embodiment of the vertebral segment 15 has in its front and rear side walls 16 and 17 a larger number of long hole-like openings 18 , of which only the openings 18 of the front side wall 16 and also the front side wall 16 are visible in FIG. 2.

As can also be seen from FIG. 2, the vertebral segment 15 has a width B, which can range from approximately 13 to 20 mm. This width also applies to the vertebral segment 1 from FIG. 1.

The length L, which is given in the side view from FIG. 2, is approximately 22.5 mm in the exemplary embodiment from FIG. 2. This length L is only approximately 20.5 mm for the exemplary embodiment of FIG. 1. This length L is essentially dependent on the type of set and the length of the vertebral body in which the vertebral segment 1 or 15 is to be used. Several different lengths L are provided, which can be varied, for example, in the ranges of 20 mm, 22 mm, 24 mm and 26 mm. In this length range from 20 mm to 26 mm, finer gradations z. B. can be provided in 1 mm steps or smaller. The total length can also be selected to be greater than 26 mm or less than 20 mm, which, as already mentioned, depends on the respective conditions of use.

Since the human spine regularly has a curved course, the upper front limiting surface 19 and the lower boundary surface 20 of the vertebral segment 15 are each arranged in an inclined plane 21 and 22 , respectively, which has an inclination angle β of approximately 1 ° to 3 ° a transverse central plane 24 running transversely to the longitudinal central axis 23 of the vertebral segment 15 . This angle of inclination β serves to adapt the spinal segment 15 to this curvature of a human spine.

Such an inclined course also have the two end faces 6 and 7 of the belsegmentes 1 of FIG. 1.

As is apparent from the plan view of Fig. 2, the two side walls 16 and 17 of the vertebral segment 15 symmetrically to the vertical longitudinal center plane 25 of the We belsegmentes arranged 15 and extend at a helix angle α of about 3 ° to 7 ° tele bene to this median longitudinal 25. The front outer wall 26 of the vertebral segment 15 is slightly curved outwards, while the parallel to the rear outer wall 27 running parallel to this extends approximately parallel to the front outer wall 26 . The vertebral segment 15 is rounded in its corner regions, the radius of curvature being approximately 2 to 3 mm. In the two corner areas 28 and 29 of the vertebral segment 15 , two screw-in threads 30 and 31 are also provided, which serve to receive corresponding fastening screws.

Fig. 3 shows a further embodiment of a We segment 35 , which differs from the embodiment of the vertebral segment 15 of FIG. 2 only in its length L, which for example has approximately 26.5 mm in the vertebral segment 35 .

Also, the side slot-like openings 36 , the number of which is also four, as in the exemplary embodiment of FIG. 2, are arranged at a greater axial distance from one another in the corresponding side walls 37 and 38 , respectively. As can be seen from FIG. 3, the Wirbelseg element also has corresponding screw threads 41 and 42 in the region of its front upper and lower boundary surfaces 39 , 40 , which are also arranged in the region of the front outer wall 45 . A screw thread 41 and 42 extend 35 at an angle δ of approximately 3 ° to 5 ° to a parallel 43 to the longitudinal center plane 44 of the vertebral segment 35 . As can be seen from FIG. 2, this angle of inclination δ is also provided for the vertebral segment 15 for its screw threads 30 and 31 .

The exemplary embodiments of the vertebral segments 1 , 15 and 35 are common to the angle and radius information given above for FIGS . 2 and 3. This means that the swirl segments 1 , 15 and 35 have substantially the same cross-sectional shape and that their screw threads 13 , 14 and 30 , 31 and 41 , 42 also in the same manner in the area of their respective front outer wall 3rd or 32 and 45 are arranged.

Furthermore, for the exemplary embodiment in FIG. 2, a depth T is indicated, which can be in a range from approximately 12 mm to 18 mm and is also dependent on the respective operating conditions of the insert segment or of the swirl segment 15 . This specified range of depth T is also applicable to the exemplary embodiments of the swirl segments 1 and 35 .

Fig. 4 shows a further embodiment of an A segment segment, which is formed out as an intervertebral disc segment 50 .

The intervertebral disc segment 50 also has a front outer wall 51 which runs parallel to its rear side wall 52 and the narrow side of the likewise trapezoidal intervertebral disc segment 50 bil det.

The disc segment 50 also has a front side wall 53 and a rear side wall 54 which symmetrically to the vertical longitudinal center plane 55 of the belt sheave segment are arranged 50th The oblique course of these two side walls 53 and 54 to the longitudinal center plane 55 of the intervertebral disc segment 50 corresponds to the oblique course of the exemplary embodiments of the vertebral segment 1 from FIG. 1, and the vertebral segment 15 from FIG. 3 and the vertebral segment 35 from FIG. 3 the intervertebral disc segment 50 has an upper end-side boundary surface 56 and a lower end-side limit surface 57 , both of which are each provided with a groove profile 58 and 59 , respectively. This groove profiles 58 and 59 each lie in a plane of inclination 68 and 69, respectively to a parallel plane 67/1 or 67/2 for the transverse center plane 67 at an inclination angle β of about 1 ° inclined to 3 ° is arranged to run. This inclined profile of the groove profiles 58 , 59 or the associated boundary surfaces 56 , 56 is used for the appropriate consideration and adaptation of the intervertebral disc segment 50 to the curved profile of a spine.

As can be seen from the front view of FIG. 4 of the intervertebral segment 50 , the front outer wall 51 has a central screw thread 60 , which, as can be seen from FIG. 5, is drilled into a corresponding through hole 61 . This screw thread 60 is used to attach a corresponding handling tool, which can be screwed into the screw thread 60 so that the intervertebral disc segment 50 can be positioned in a simple manner in a pocket-like recess in an intervertebral disc or between two adjacent vertebral bodies. After the positioning of the intervertebral segment 50 in its desired position, the handling tool can be screwed out of the screw thread 60 accordingly.

As can be seen from Fig. 4 in the top view or in the Seitenan view, the intervertebral disc segment 50 in the corner region between the two side walls 53 and 54 and the rear outer wall 52 each have a through hole 62 and 63 , which for fastening or for Combination of the intervertebral disc segment 50 with one of the vertebral segments 1 , 15 or 35 serve. Thus, the distances between these through holes 62 and 63 are matched to the distances of the corresponding screw threads 13 , 14 or 30 , 31 or 41 , 42 of the vertebral segments 1 or 15 or 35 , so that a precise hold of the intervertebral disc segment 50th on the corresponding vertebral segments 1 , 15 or 35 is ensured. As can be seen from the side view and the top view of FIG. 4, the through bores 62 , 63 each have an approximately cylindrical depression 64 and 65 , respectively, for receiving a corresponding screw head of a fastening screw 66 , as exemplified in FIG. 10 is shown.

Next 10 the combinability of FIG. Exemplary of the spinal segment 15 and the disc segment 50 is shown.

Furthermore, it can be seen from Fig. 10 that 15 different lengths can be provided for the We segment segment, these different lengths are indicated in Fig. 10 by a plurality of phantom lines 70 . The same applies to the intervertebral disc segment 50 . Here, too, different total lengths are provided, which are indicated in phan tom lines 90 , so that the combination of different intervertebral disc segments 50 and under different vertebral segments 1 , 15 or 35 also under different total lengths of the entire insert body, consisting of vertebral segments 1 , 15 or 35 and intervertebral discs segment 50 can be reached. The combination of the intervertebral disc segment 50 and the vertebral segment 15 also results in a variation of the helix angle reicht, which in this case is doubled by the helix angle β of both the intervertebral disc segment 50 and the vertebral segment 15 , so that the total angle χ is twice the inclination angle β speaks accordingly.

From Fig. 11 it can be seen that the fastening screws supply screws 66 are, for example, slotted cylinder head screws, through which a firm hold of the intervertebral disc segment 50 on the vertebral segment 15 is ensured. As can also be seen from Fig. 10, the groove profiles 58 and 59 of the intervertebral disc segment 50 are matched to the grooved profile 8 and 9 of the vertebral segment 15 , so that a secure hold of the intervertebral disc segment 50 on the vertebral segment 15 is ensured.

Fig. 8 shows a combination of the vertebral segment 15 with two intervertebral disc segments 50 in an inserted state in a spine 71st In Fig. 8, an upper vertebral body 72 , a middle vertebral body 73 and a lower vertebral body 74 and a lower vertebral body 75 is shown in section. In the middle We belkörper 73 a recess 76 is milled, in which the vertebral segment 15 is inserted appropriately.

As can be seen from Fig. 9, the recess 76 corresponds in its outer dimensions essentially to the tra pez-shaped design of the vertebral segment 15 or the intervertebral disc segment 50 .

As can be seen from FIG. 8, the inclination angles of the uppermost boundary surface 58 of the intervertebral segment 50 and the lowest boundary surface 58 of the intervertebral segment 50 placed below on the vertebral segment 15 are matched to the curved course of the spine 71 such that the combination of the vertebral segment 15 and the two disc segments 50 is stuck at the correct angle between the upper vertebral body 72 and the lower We belkörper 74 appropriately. As it is evident from FIG. 8, the two intervertebral disc segments 50 are each firmly connected to the vertebral segment 15 by means of corresponding fastening screws 66 , so that a tightly fitting fit of the entire insert body, consisting of the vertebral segment 15 and the two connected to it Intervertebral disc segments 50 is reached.

For additional support and for ingrowth of vertebral segment 15 and the disc segments to improve 50 in the inner cavity of Wirbelseg can mentes 15 and the disc segments are introduced 50 autologous cancellous bone 79, which can grow together with advancing tendem healing process with the vertebral bodies 73 . However, this measure is not absolutely necessary. Hydroxyapatite can, however, also be provided for filling the intervertebral disc segment 50 or the vertebral segment 15 , although this is also not absolutely necessary. Over the period of time in which a set body from vertebral segment 15 and intervertebral disc segments 50 is inserted into the recess 76 of the vertebral body 73 , the bone material of the vertebral body 73 grows into the recesses 11 of the vertebral segment 15 , so that a firm hold over the duration guarantees is steady.

For additional securing of the insert body, consisting of vertebral segment 15 and intervertebral disc segments 50 , an additional holding plate 80 can be provided, the more detailed configuration of which is shown in FIGS. 6 and 7. This holding plate is indicated in FIGS. 8 and 9 in dashed lines. This holding plate 80 is held firmly in the upper vertebral body 72 and the lower vertebral body 74 by means of corresponding fastening screws, which are indicated by the center lines 81 and 82 . This reliably prevents the insert body from coming loose, particularly in the period shortly after its operative insertion into the central vertebral body 73 . This additional holding plate 80 is also not absolutely necessary, but can be used at any time for safety purposes.

As can also be seen from FIG. 8, the intervertebral disc segment 50 can also be inserted directly into an intervertebral disc 83 , wherein it is securely held in a pocket-like recess 84 which is correspondingly provided in the intervertebral disc by its groove profiles 58 and 59 . The intervertebral disc segment 50 can also be provided for the complete replacement of such an intervertebral disc 83 if a corresponding extensive damage to this intervertebral disc makes a complete corpectomy of the intervertebral disc necessary. In this case, of course, the axial length of the intervertebral disc segment 50 is made larger than shown in FIG. 8. It may just be necessary here to edit the two adjacent vertebrae 74 and 75 to the disc segment 50 towards oberflächensei tig to securely hold the tape Schei bensegmentes 50 between the two vertebral bodies 74 and 75 to ensure safe.

The additional holding plate 80 shown in FIGS. 6 and 7 essentially has a width which is somewhat larger than the maximum width of a vertebral segment 1 , 15 or 35 . To attach the holding plate 80 , the se has several countersunk outer through holes 85 and middle slots 86 , which are optionally screwed together for Ver the holding plate 80 with the corresponding We belkörpern 72 , 74 in the holding plate 80 are arranged differently. Through this, as shown in FIG. 6, a plurality of these through bores 85 or slots 86 , a universal fastening possibility of the holding plate 80 is ensured on the one hand on the vertebral body and, if necessary, at least on the intervertebral disc segments. As can be seen from FIG. 7, the holding plate 80 can have a pre-curved course which is adapted to the curvature of a vertebral body or a vertebral segment 1 , 15 or 35 , so that modeling to the vertebral shape is considerably simplified. As can be seen in particular from FIGS . 8 and 9, this modeling is possible due to the thin design of the holding plate 80 .

As from the above description of the individual components le of the insert body together with the holding plate is visible, is an on by this insert body sentence segment for replacement or partial replacement of a We belbody or an intervertebral disc or both provided which in the simplest way in a vertebral body or an intervertebral disc in one chend there can be used ventrally attached recess.  

By profiling the corresponding end faces becomes a secure hold either between the vertebrae or ensured between two adjacent intervertebral discs. As an additional hold, especially of the vertebral segment serve the through openings in its side walls, in which the bone material after the operation can grow at least partially during the period and thus a lifelong secure hold of the vertebral segment possibly together with appropriate intervertebral disc segments ten is ensured.

It is understood that on each face of a vertebra segment also several intervertebral disc segments one above the other can be arranged so that on the one hand an additional Liche possibility for angle adjustment to the curved Course of the spine and a length adjustment to the different distances between two vertebrae are possible is.

Claims (11)

1. insert body for insertion into a, in a vertebral column of a human from the ventrally attached recess, which is formed from an essentially tubular insert segment, characterized in that
that the tubular insert segment ( 1 , 15 , 35 , 50 ) has an approximately trapezoidal outer cross-section with two parallel outer walls ( 2 , 3 , 26 , 27 , 45 , 51 , 52 ), and
that the insert segment ( 1 , 15 , 35 , 50 ) in the recess ( 76 ) of the spine ( 71 ) is suitable and fully dig used, and
that the wider of the two outer walls ( 3 , 26 , 45 , 52 ) with its outer surface in the inserted state is essentially flush with the outer surface of the spine and,
that the end faces ( 6 , 7 , 19 , 20 , 39 , 40 , 56 , 57 ) of the insert segment ( 1 , 15 , 35 , 50 ) each have a groove profile ( 8 , 9 , 58 , 59 ) running transversely to the direction of insertion are provided. 2. insert body according to claim 1, characterized in that the insert segment for insertion into a vertebral body as a vertebral segment ( 1 , 15 , 35 ) is ausgebil det and,
that the axial length (L) of the vertebral segment ( 1 , 15 , 35 ) corresponds approximately to the axial length of the vertebral body ( 72 , 73 , 74 , 75 ) or,
that the axial length of the vertebral segment ( 1 , 15 , 35 ) is matched to the distance between the two vertebral bodies ( 72 , 74 ), which is the vertebral body ( 73 ) in which the vertebral segment ( 1 , 15 , 35 ) is arranged, are neighboring. 3. Insert body according to claim 1, characterized in that the tubular insert segment for insertion into an intervertebral disc is formed as an intervertebral disc segment ( 50 ) and has an axial length which essentially corresponds to a maximum of approximately the thickness of the intervertebral disc ( 83 ). 4. insert body according to claim 2 and 3, characterized in that the vertebral segment ( 15 ) can be combined with at least one intervertebral disc segment ( 50 ) to form an insert body and that the intervertebral disc segment ( 50 ) in the inserted state of the vertebral body ( 73 ), in which the We belsegment ( 15 ) is used, completely replaced adjacent intervertebral disc. 5. Insert body according to claim 2, 3 or 4, characterized in that the vertebral segment ( 1 , 15 , 35 ) for setting different total lengths on one or both sides on its end face limitation surfaces ( 6 , 7 , 19 , 20 , 39 , 40 , 56 , 57 ), each with one or more intervertebral disc segments ( 50 ), can be combined to form an insert body. 6. Insert body according to claim 4 or 5, characterized in that the vertebral segment ( 1 , 15 , 35 ,) with the intervertebral disc segment ( 50 ) by a screw connection ( 13 , 14 , 29 , 30 , 41 , 42 , 66 ) can be firmly connected is. 7. Insert body according to one of claims 1 to 6, characterized in that the oblique to the parallel len outer surfaces ( 2 , 3 , 26 , 27 , 45 , 51 , 52 ) of the A segment ( 1 , 15 , 35 , 50 ) extending Seitenwän de ( 4 , 5 , 16 , 17 , 53 , 54 ) symmetrical to the longitudinal center ( 25 , 44 , 55 ) of the insert segment ( 1 , 15 , 35 , 50 ) are arranged. 8. insert body according to claim 7, characterized in that the side walls ( 4 , 5 , 16 , 17 , 37 , 38 ) of the vertebral segment ( 1 , 15 , 35 ) each provided with a plurality of elongated perforations ( 11 , 18 , 36 ) are. 9. insert body according to one of claims 1 to 8, characterized in that the insert segment ( 1 , 15 , 35 , 50 ) by a holding plate ( 80 ) in the recess of the spine ( 76 ) is additionally fixable and that the holding plate ( 80 ) on the insert segment ( 50 ) and on the insert segment ( 50 ) adjacent vertebral bodies ( 72 , 74 ) can be fastened. 10. Insert body according to one of claims 1 to 9, characterized in that the insert segment ( 1 , 15 , 35 , 50 ) and the holding plate ( 80 ) are made of a titanium alloy. 11. Insert body according to one of claims 1 to 10, characterized in that the front limita tion surfaces ( 6 , 7 , 19 , 20 , 39 , 40 , 56 , 57 ) of the A segment ( 1 , 15 , 35 , 50 ) symmetrical to the transverse central plane ( 24 , 67 ) extending transversely to the longitudinal central axis ( 23 , 55 ) of the insert segment ( 1 , 15 , 35 , 50 ) and each having an inclination angle (β) of approximately 1 ° to 3 °.