CN1795834A - 应用于骨或椎骨的稳定装置中的弹性元件 - Google Patents

应用于骨或椎骨的稳定装置中的弹性元件 Download PDF

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CN1795834A
CN1795834A CNA2005101251046A CN200510125104A CN1795834A CN 1795834 A CN1795834 A CN 1795834A CN A2005101251046 A CNA2005101251046 A CN A2005101251046A CN 200510125104 A CN200510125104 A CN 200510125104A CN 1795834 A CN1795834 A CN 1795834A
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CN1795834B (zh
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L·比德曼
W·马蒂斯
J·哈姆斯
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Biedermann Technologies GmbH and Co KG
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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
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7026—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7011—Longitudinal element being non-straight, e.g. curved, angled or branched
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped

Abstract

本发明涉及一种应用于骨或椎骨的稳定装置中的弹性元件。该弹性元件具有一第一端和一第二端以及一在它们之间延伸的部分，此部分为一曲回形成形的撑条的形式，其中，曲回沿连接轴线从第一端向第二端交替地在连接轴线的两个相反的侧面延伸。

Description

应用于骨或椎骨的稳定装置中的弹性元件
技术领域
本发明涉及一种应用于脊柱外科或创伤外科中的弹性元件、以及分别具有这样的弹性元件的一种骨锚定元件、一种撑条形元件和一种稳定装置。
背景技术
为了固定骨断裂或为了稳定脊柱，固定和稳定装置是已知的，其包括至少两个锚定于骨或椎骨中的并经由一板或一撑条连接的骨螺钉。这样的刚性系统不允许固定的各骨部分或椎骨发生任何相互相对运动。
但是对于一定的适应症，动态的稳定是所期望的，其中待稳定的各骨部分和椎骨可以实现一受控的有限的相互相对运动。实现动态稳定装置的一种方案在于采用一弹性元件代替一连接骨锚定元件的刚性撑条。
由US 2003/0 191 470 A1已知一种用于连接各骨螺钉的弹性元件，其在从静止位置偏移时施加一回复力。由于曲回式构成的撑条中间区域设置在撑条轴线一侧，弹性元件具有一不对称的形状并且其产生撑条的局部强的负荷。
由US 6,440,169 B1已知一种用于稳定椎骨的弹性元件，其中两个构成为片簧的元件可以沿椎骨的连接轴线实现一有限的压缩运动。
由US 2003/0 220 643 A1已知一种用于连接两骨螺钉的撑条，其具有一螺旋弹簧形的弹性部分。该弹性部分的弯曲刚度在垂直于撑条轴线的全部方向上是相同的，并从而不存在定向的弯曲刚度。
发明内容
本发明的目的是，提供一种改进的弹性元件，其垂直于撑条轴线具有与方向有关的弯曲刚度并且在循环载荷下具有高的强度，而且可以与其他的元件一起以尽可能各种各样的方式组合成一椎骨或骨的动态稳定装置。
该目的通过按照权利要求1所述的弹性元件来达到。
本发明的进一步构成说明于诸从属权利要求中。
本发明的优点是，弹性元件构造成紧凑的并同时具有一种与方向有关的弯曲刚度。这特别是对于应用到脊柱上并且在那里特别应用到颈脊柱上具有意义，因为在那里供使用的空间与应用到腰脊柱上相比要小得多。此外其几何形状易于适应于不同的要求，因为可以达到大范围的弹簧性能。
此外本发明的优点是，由于相对于两端的连接轴线的近似对称的设计，回复力相对于从静止位置的相反的偏移是对称的，并且在循环载荷下的材料载荷比在已知的弹性元件中更为均匀地分布，这就提高了使用寿命并减小由于材料疲劳而破裂的危险。
此外，达到一沿平均长度几乎不变的弯曲应力。通过动态的轴向偏移(Einfederung，挠曲)产生一优点，以便在应用到一小面关节(Facettengelenk)上时保持平移运动，借此避免关节病。
此外，本发明的优点是，一弹性元件按照选择可以与其他的元件一起组合成一动态稳定体，从而对各种需求具有高度的适应能力。
附图说明
通过对附图中示出的实施例的描述得出本发明的其它的特征和优点。其中：
图1按照第一实施形式的弹性元件的透视图；
图2按照第一实施形式的弹性元件的侧视图；
图3按照第一实施形式的弹性元件的一部分的透视详图；
图4按照第二实施形式的弹性元件的透视图；
图5按照第二实施形式的弹性元件的侧视图；
图6按照第三实施形式的弹性元件的透视图；
图7按照第三实施形式的弹性元件的侧视图；
图8按照第四实施形式的弹性元件的透视图；以及
图9包括一弹性元件的稳定装置的应用的示意局部剖视图。
具体实施方式
第一实施形式：
以下参照图1和2描述本发明的第一实施形式。
在图1和2所示的第一实施形式中该弹性元件具有一第一端10、一第二端20和一在中间设置的弹性部分30，它们一体地构成。弹性元件由身体相容性的(即生物相容性的)材料例如钛制成，它也可以由身体相容性的形状记忆合金制成，其具有超弹性，例如由镍钛诺(Nitinol)制成。
第一端10和第二端20有圆柱形横截面，其中圆柱体轴线平行于第一端10、弹性部分30和第二端20的连接轴线Z设置。在第一端10上向部分30的方向连接一锥形部分11，其从第一端10的圆柱体横截面向弹性部分30的横截面成锥形变宽。同样第二端20连接一锥形部分21。
弹性部分30紧接着锥形部分11并且构造成曲回形成形的扁撑条32的形式，其具有基本上矩形的横截面。如图2的侧视图中所示，弹性部分30的曲回形状从锥形部分11向锥形部分21延伸并且曲回凸鼓部31基本上以正弦形变化沿方向X垂直于连接轴线Z交替地向连接轴线的一侧X+和向另一侧X-延伸。图1和2中例如在X-侧示出两个曲回凸鼓部31a、31c而在X+侧示出一个曲回凸鼓部31b。但可以按要求的弹性元件的特性选择曲回凸鼓部的数目。此外，在应用于骨和椎骨的稳定装置中时可以按照锚定元件的间距和必需的弹性元件的弹性特性选择圆柱形端10、20的长度和弹性部分30的长度。
沿垂直于连接轴线Z和方向X设置的方向Y，弹性部分30沿其全长具有一不变的宽度ds。在所示的实施形式中，除紧邻变宽的边缘11和变宽的边缘12的部分33，34具有一较大的直径之外，曲回形构成的扁撑条32沿其延伸在垂直于方向Y上具有一不变的直径。
以下借助图3更详细地描述弹性部分30。图3中详细示出弹性部分的尺寸，其对弹性特性具有一重要的影响。通过改变参数ds(弹性部分沿方向Y的宽度)、b(波的双倍振幅)、h(半波长)、da(曲回凸鼓部沿方向X的材料厚度)和di(在过零点(过连接轴线)沿连接轴线Z的方向的材料厚度)可以使弹性部分的弹性特性适应于希望的要求。以下参照图3讨论这些影响。
通过弹性部分30构成一曲回形成形的扁撑条32的形式达到，弹性元件具有关于绕连接轴线Z的扭转的高的扭转刚度并同时具有关于在方向Y上的弯曲载荷，亦即关于绕一沿方向X延伸的轴线的弯曲的高的弯曲刚度。相反，关于在方向X的弯曲载荷，亦即关于绕一沿方向Y延伸的轴线的弯曲具有高的弹性，并且如果需要的话，关于沿连接轴线Z的方向的压缩和拉伸也可具有高的弹性。
例如，通过加大弹性部分沿方向Y的宽度ds可以同时提高扭转刚度和在方向Y上的弯曲刚度。通过其他的参数h、da、di和b的相应的选择，可以有针对性地调整弯曲刚度和沿连接轴线Z的弹性的弹簧性能。
图9中示意示出弹性元件的示例性应用，其中第一和第二端10、20分别安装于一多轴线骨螺钉的一容纳件40中。其中各多轴线骨螺钉以其撑条1锚定于一脊柱的邻接的椎骨W中并且各骨螺钉的钉头2可在相应的容纳件40中转动和经由一固定元件可锁定地保持在它们的角度位置。
在这样的设置中，通过弹性元件的应用能够实现各椎骨之间的受控的运动，即能够实现沿弹性元件的连接轴线Z的方向的弹性平移和在方向X上的弹性弯曲运动，而在相当大程度上阻止扭转运动和在方向Y的弯曲运动。
通过合适地选择参照图3中描述的各参数，可以按简单的方式调整弹性元件关于受控的运动所要求的特性，并且利用不同特性的弹性元件与单轴线的或多轴线的骨螺钉和撑条或板的组合给出高的可变性。
第二实施形式：
图4和5中所示的第二实施形式与第一实施形式的区别主要在于弹性部分的设计。在第二实施形式中弹性部分30’如同在第一实施形式中构成为一曲回形成形的扁撑条32’的形式。曲回形状与在第一实施形式中的区别在于，不是正弦形而是曲回形的或折回式的延伸，其中曲回凸鼓部31’具有更凸鼓的形状，其在侧视图中围成滴状的空白区域35’。在该实施形式中，两邻近的曲回凸鼓部31’a和31’b的侧面36’与第一实施形式相比相互间只具有微小的间距。
通过该特殊的实施形式可以限制沿连接轴线Z的弹性的偏移并同时通过合适地选择其他的参数。如同在第一实施形式中，可以按需要调整其他的方向上的弯曲刚度。
第三实施形式：
图6和7中所示的第三实施形式与第二实施形式的区别在于，弹性部分30”在邻近的曲回凸鼓部31”a与31”b之间具有一与曲回凸鼓部31”b成一件连接的突起部37”b以及在连接轴线Z的另一侧在邻近的曲回凸鼓部31”c与31”d之间具有一与曲回凸鼓部31”d成一件连接的突起部37”d。
突起部37”b和37”d在这里构造成使它们的面向邻近的曲回凸鼓部31”a或31”c的侧面基本上顺着后者的走向延伸并且相对其具有小的间距。另一外面基本上沿从曲回凸鼓部31”b或31”d向邻近的曲回凸鼓部31a”或31”c的连接线延伸，但不与其连接。
通过该特殊的实施形式达到，限定弹性元件沿连接轴线Z的偏移并同时也可以限制在方向X上的弯曲运动或平移运动。
第四实施形式：
在图8中所示的第四实施形式中与图4和5中所示的第二实施形式相比，弹性部分130的曲回形成形的扁撑条132的折回式延伸是更为显著的。通过该加强的折回形状，扁撑条132沿连接轴线Z观察在弹性部分130的中间具有一S形构成，从而沿方向X的两曲回凸鼓部131并排设置。
在该实施形式中优点是，与第一至第三实施形式的弹性部分相比缩短了弹性部分130，从而一较紧凑的构造方式是可能的。
其他的实施形式和变型方案：
例如有可能进一步改变弹性部分的横截面形状或改变在扁撑条的延伸方向上的横截面形状。同样第一端和第二端可以具有不同的形状或不必一定要与弹性部分构造成一件式的。
弹性元件在不同于图9中所示的骨或椎骨的稳定装置中的应用当然也是可能的。
此外，其他的扁撑条的横截面例如具有倒圆的边棱的矩形横截面也是可能的。

Claims (10)

1.应用于骨或椎骨的稳定装置中的弹性元件，它具有一第一端和一第二端以及一在它们之间延伸的部分，此部分为一曲回形成形的撑条的形式，其中，曲回沿连接轴线从第一端向第二端交替地在连接轴线的两个相反的侧面延伸。
2.按照权利要求1所述的弹性元件，其特征在于，曲回形成形的撑条具有一种扁撑条的横截面。
3.按照权利要求1或2之一项所述的弹性元件，其特征在于，曲回形成形的撑条垂直于延伸方向具有一基本上矩形的横截面。
4.按照权利要求1至3之一项所述的弹性元件，其特征在于，设有至少两个曲回凸鼓部，它们处在连接轴线的相反的两侧。
5.按照权利要求1至4之一项所述的弹性元件，其特征在于，曲回形成形的撑条垂直于曲回凸鼓部的方向和垂直于连接轴线具有一均匀的宽度。
6.按照权利要求1至5之一项所述的弹性元件，其特征在于，垂直于撑条轴线的周长在第一端或第二端的区域内比在形式为曲回形成形的撑条的部分内小。
7.按照权利要求1至6之一项所述的弹性元件，其特征在于，形式为曲回形成形的撑条的部分的横截面沿全长是不变的。
8.按照权利要求1至7之一项所述的弹性元件，其特征在于，弹性元件的一端具有圆形横截面。
9.按照权利要求1至8之一项所述的弹性元件，其特征在于，弹性元件构造成一用以连接两个骨锚定装置的撑条的一部分。
10.用于骨、骨部分或脊柱的动态稳定的稳定装置，具有至少两个骨锚定元件，它们经由一撑条形元件或一板相互连接，其中，稳定装置的一部分或一元件设计成一按照权利要求1至8之一项所述的弹性元件。
CN2005101251046A 2004-11-17 2005-11-17 应用于骨或椎骨的稳定装置中的弹性元件 Expired - Fee Related CN1795834B (zh)

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WO2019179091A1 (zh) * 2018-03-20 2019-09-26 姜国 一种颅骨减压连接器

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CN1795834B (zh) 2012-02-15
EP1658815A1 (de) 2006-05-24
DE102004055454A1 (de) 2006-05-24
KR101133191B1 (ko) 2012-04-09
KR20060055329A (ko) 2006-05-23
JP5060041B2 (ja) 2012-10-31
ES2385222T3 (es) 2012-07-19
US20060184171A1 (en) 2006-08-17
EP1658815B1 (de) 2012-03-28
JP2006142024A (ja) 2006-06-08

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