CN1870952B - Flexible implant - Google Patents
Flexible implant Download PDFInfo
- Publication number
- CN1870952B CN1870952B CN2004800305254A CN200480030525A CN1870952B CN 1870952 B CN1870952 B CN 1870952B CN 2004800305254 A CN2004800305254 A CN 2004800305254A CN 200480030525 A CN200480030525 A CN 200480030525A CN 1870952 B CN1870952 B CN 1870952B
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- Prior art keywords
- securing device
- spinal column
- tubular body
- column securing
- rod
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Images
Classifications
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- 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
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
Abstract
Implant for temporary or permanent introduction into a human or animal body of at least one biocompatible material with a shape that is oriented to fulfill one or more first functions, characterized by the fact that the shape has one or more areas (1, 18) in which, as second function, elasticity or mobility is provided, with the implant having material recesses (7, 19) in the area or areas which serve to locally reduce rigidity and are provided in addition to the shape caused by the first functions.
Description
Technical field
The present invention relates to the method for the corresponding manufacturing implant of corresponding implant of claim 1 or claim 3 preamble and claim 19 preamble.
Background technology
In modern times in the medical science, use implant to remedy or at utmost reduce human body or animal body defect influence.For example, the interval eyelid retractor of vertebra or intervertebral disc can be used for substituting vertebral body or intervertebral disc.And for example, spinal column reinforcement or stabilisation systems can be through LOCATION OF PEDICLE SCREW FIXATION is interconnected in vertebra and through connecting rod, so that mutual distance, the arrangement of vertebra can obtain adjustment and fixing.
Concerning all implants, implant material can compatiblely with human or animal's body be very important, that is to say, does not cause that rejection perhaps can be owing to its decomposing phenomenon causes body burden.Therefore, the material of implant is selected to come down to restricted.
In addition; Preferably as far as possible simply particularly to process implant with the mode of fewer parts; Because the combination of parts need increase the surgery cost of the implant of packing into, on the other hand, thereby in the interconnective place of various parts more easy error more possibly break down.Therefore, incorporate implant is processed in special recommendation.
Yet, in contrast be, implant must realize multiple function, this hopes to use material different again and/or forms implant by different parts.Such as, hope that for sept they all not only realize packing space and keep the function of the certain distance between vertebrae adjacent, and they also help mutual motion certain between each vertebra, promptly in certain narrow range, play a part similar joint.For this reason; Can adopt such as according to the described interval of DE 10056977 C2 eyelid retractor; Wherein between the support member adjacent with vertebral body, be furnished with process by woven fabric or fabric material closely, implant vertically on the pipe fitting of stretchable bellow-shaped.But this has brought foregoing shortcoming: need to use several kinds of different materials that must interconnect, and this has just increased the probability of makeing mistakes.And, be the implant of its advantage though i.e. tensility, compressibility and the flexible specifically of certain elasticity arranged, because up to the present the problem that relevant interconnection technique recited above or material are selected still is not put into limit of consideration.
From EP0669109B1, can know a kind of like this securing device of stabilize adjacent vertebrae: it comprises 2 single shaft pedicle screws and a bands; This ribbon is fixed on the reception position of pedicle screw respectively by a trip bolt; This said device also comprises several support components, for being enclosed within the withstand voltage body on the ribbon.Yet except a lot of shortcoming of various parts, this securing device also has a problem, and promptly it just no longer includes elasticity when putting support component.Use the single shaft pedicle screw further to limit the application of this securing device.From EP1188416A1, can know another kind of similarly securing device, wherein use multiaxis pedicle screw rather than single shaft pedicle screw.
From US2003/0109880A1, can know a kind of so dynamic vertebra securing device: this device comprises first screw and second screw that is anchored on the vertebra, and each screw all is useful on reception position and the such spring that inserts a spring that couples together screw.Spring self do as a whole form the closely adjacent helical spring shape of coil and be fixed on the extension spring form through trip bolt receive the position.But also there is risk in this device, promptly owing to the elastic buckling of spring to trip bolt pressure, thereby fixing the relaxing between bone screw and the spring.
Summary of the invention
Therefore the purpose of this invention is to provide such implant, it is made up of simple as far as possible parts, particularly by one or easily several of connection form; And wherein except other function, guarantee that implant or its some zones have certain elasticity and activeness.In addition, this device should be easy to make, implant, and is safe in utilization, durable in use and be widely used.
Above-mentioned purpose realizes through following implant.
The present invention provides a kind of spinal column securing device, and it comprises first bone anchoring element, and it is used to anchor into vertebra, and said first bone anchoring element has the first end seat; Second bone anchoring element, it is used to anchor into vertebra, and said second bone anchoring element has the second end seat; And link; Through said link is contained in said first end seat and the said second end seat; Said link is set to said first bone anchoring element is connected to said second bone anchoring element; Said link comprises: first rigid portion, and it has the first rigid tubular body, and the said first rigid tubular body is set to be connected to said first bone anchoring element; Second rigid portion, it has the second rigid tubular body, and the said second rigid tubular body is set to be connected to said second bone anchoring element; And elastic; It has the elastic tubular body of band spiral depression; Said elastic tubular body is arranged as between said first rigid portion and said second rigid portion, and wherein, said spinal column securing device also comprises and is used for substituting the intervertebral disc adjacent with said link or the interval eyelid retractor of vertebra; Said interval supporter has tubular body, and said tubular body has the elastic segments of band spiral depression.
The present invention builds on following understanding: about being used for the implant of human body and animal body, shape is to select according to its that implant is realized at body or multinomial function basically.These functions possibly comprise also that implant has activeness or elasticity to a certain degree.And under some other situation, activeness or elasticity in the implant are dispensable basically, but possibly be preferably can have or had can be more favourable.About this point, in the explanation below, activeness and spring function will be called as secondary function, and all the other functions are called premiere feature.
In first group of situation, prior art is to obtain activeness or elastic through optional feature and/or dissimilar materials.Another approach has been adopted in this invention; Wherein activeness or elasticity are not to realize through other material or additional separate part; But in implant that forms as one or implant component, the zone through the design of material recess being stipulated realize to have elasticity or activeness.
In second group of situation, activeness or elasticity are not indispensable functions, according to the present invention, realize this additional function through the additional in shape respective material depression that is provided with in the respective regions in the required function regulation yet.
In this way, just can avoid adopting additional elastomeric material and corresponding link or additional individual components, and obtain the elasticity and the activeness of implant or its parts with simple mode.About this respect, elasticity or activeness function can be additional settings the outside the necessary function of implant, perhaps as the ingredient of necessary function.Particularly, so just can particularly in the implant that is integrally formed or its parts, produce compression and/or drawing zone and in certain restriction, form bending joint or torsion element etc. with the better way mode.
Correspondingly, can use stablely, hard for the implant that is preferably formed as one, particularly under the application-specific condition, use inflexible, preferably resilient rigid material such as titanium, titanium alloy, plastics or the like.In general, all can not cause rejection or occur bringing the biocompatible materials of the decomposing phenomenon of burden to body can be candidate material.
Groove-like depression or perforate that material recess preferably forms on the wall of implant or implant component.The shape of material recess, quantity and arrangement can be adjusted to meet load request according to concrete condition.
As a kind of common shape that satisfies multiple requirement; Material recess is particularly suitable for forming the helical form around the implant Subject Extension; Thereby form the shape of helical spring type especially, and be particularly suitable for through material recess forming free space between the adjacent spiral bar in helical spring element.Except easy production, associated materials select face wider, it also is beneficial to the bigger elasticity of realization.
Particularly advantageous is that two material recess can form the spiral type of parallel in pairs or round trip flight.Like this, can form two helical springs that mutual embedding contains layout especially.If the height of this helical form sunk area is identical, the single-screw shape depression of so double pitch Double helix shape depression instead low pitch.
Elastic implant is particularly suitable for; Also especially obviously be suitable for using together as a system; The interval eyelid retractor of vertebra and/or intervertebral disc and the connecting rod of pedicle screw device are so that patient's spinal column has the activeness of appropriateness when keeing relative stability again.
Support and weight transfer function are the premiere features of vertebra and/or intervertebral disc space eyelid retractor at interval, and damping effect and activeness are the additional functions as second function.
Support and linkage function are its premiere features for connecting rod.
For implant or interval eyelid retractor or connecting rod; Confirmed preferably to make it to form the tubular body that has the intermediate tubular body and Connection Element is arranged in the end; And be used for obtaining elastic material recess and be preferably formed as form, thereby make these parts form the helical spring shape that one or two mutual embedding contains layout basically into one or two spiral-shaped orifices of tubular body.At interval the Connection Element of eyelid retractor preferably has the device that connects adjacent body area such as vertebra, as at the hamulus of end and/or at depression, groove and the opening of superficies so that at interval eyelid retractor can grow into tissue and with its weave in.But in this, not being used to obtain the elasticity of interval eyelid retractor in the hole of this Connection Element or depression and the tubular body and the material recess of activeness is obscured mutually.Since Connection Element fully with adjacent body area such as the vertebra weave in, they are not made contributions to the elasticity or the activeness of vertebra.
The device that is connected to tubular body adjacent body area can be arranged to, or is integrally formed the particularly mode through extending in the tubular body end with tubular body, or the separable end plate that for example can be screwed on the tubular body end in end.
During the end plate that adopts this separable end plate or link into an integrated entity with tubular body, be preferably in and sleeve that an elastomeric material processes be set at least around the tubular body that has material recess to realize elasticity or activeness; Or an elastomeric core is set at least in tubular body.This elastomeric core or the resilient sleeve of preferably being processed by artificial rubber has elasticity or the inflexible benefit that can accurately regulate tubular body or interval eyelid retractor.Through tubular body and the core and/or the arrangement of telescopic module shape of band respective recesses, the different assemblies of use different-stiffness just can obtain accurately to limit with the damping meaning implant of rigidity with simple mode.Here, have the implant component that can obtain elastic material recess with by one can adjust implant component that the elastomeric material that limits rigidity forms to combine be the very basic purpose of the present invention.Be to obtain the rigidity of change, as long as change the combination of parts, promptly such as as long as reinstate with another core of different-stiffness or another sleeve and elastic tubular body one.Can use with the elastic tubular body simultaneously though can expect sleeve and core, for simplicity, only use tubular body and core or tubular body and telescopic a kind of combination usually.Here, sleeve also has the advantage that tubular body that protection has a depression of spiral type does not preferably receive external action, yet in contrast, when using core, core receives the protection of tubular body.
Core and sleeve preferably can both use under the telescopic situation through arranging that in the tubular body end end plate fixes, and therefore end plate preferably forms bigger diameter than tubular body from tubular body is outstanding.End plate can partly promptly fuse in a side and tubular body at least, thereby forms beaker shape at this.In addition, end plate can also be at one end or two ends be connected separably with tubular body, such as through screw or be threaded.Here, external screw thread can be located on the end plate, also can be located on the tubular body.
Preferably; This implant or have is used for obtaining the tubular body of material recess of elasticity and activeness, and the eyelid retractor longitudinal axis can stretch or compress 0.5% to 20% along the interval in a longitudinal direction; Particularly 1% to 15%; And can be about with the perpendicular radial axle bending of the longitudinal axis of interval eyelid retractor contiguous body area being spent with respect to longitudinal axis deflection about 0.5 to 10, particularly 1 to 6 spends.In addition, in a preferred embodiment, can twist 0.5 to 2.5 degree around the longitudinal axis.
In another favourable application of flexible implant; Connecting rod in the zone between the pedicle screw device between single shaft or the multiaxis pedicle screw device can have certain elasticity and activeness through arranging corresponding material recess, and this elasticity and activeness can be that ducted body is enhanced through the part-structure of connecting rod at least especially.Rod-shaped elements is specially adapted to the firm and activeness restriction of adjacent vertebrae in the intervertebral disc defect situation of various degree.In manufacture process, obtain these characteristics through the plain mode that changes the rod-shaped elements size.
Such as, a kind of like this implant can be processed by an object with a kind of simple mode, makes one or more material recess through machinery or chemical process, edm (EDM), and laser treatment or any alternate manner are formed on the wall of object.Particularly one or preferably two material recess can spiral type around object or along the wall setting.
At object is solid during such as solid cylinder, can in front or form in the additional step of back particularly and the co-axial thorax of material recess hole, thereby preferably at Hookean region formation coil spring shape.When using tube material, with regard to unnecessary brill core.
Comparatively ideally be, process material recess through the laser treatment of tubular body, because under the sort of situation, two depressions can form in same treatment step.By laser, pass through tubular body (for example, also can be rectangular tube) the formation thorax hole in both sides simultaneously through boring.Rotate simultaneously and advance the tubulose body to form the round trip flight spiral.
On the other hand; The present invention relates to a kind of rod-shaped elements; This element is used for connecting at least two bone anchoring elements (bone-anchoring element); Each bone anchoring element is useful on anchoring section that anchors into bone and the part of accepting that is used for being connected with rod-shaped elements, and this rod-shaped elements is surrounded by at least one rigidity section and elastic segments that is formed by a material, and elastic segments particularly forms helical spring; And/or wherein on the other end of elastic segments and rigidity section adjacency, the second rigidity section and elastic segments adjacency are arranged; And/or wherein the overall diameter of elastic segments is different with the overall diameter of rigidity section a position at least, and/or wherein this elastic segments at least certain part with perpendicular certain direction of this rod axis on little than on the other direction of the overall diameter that has, and/or wherein the overall diameter of elastic segments is vicissitudinous; And/or wherein elastic segments has a core, and/or wherein is provided with a coaxial thorax hole and runs through this rod-shaped elements.
And; On the other hand; This invention relates to a kind of bone securing device; Contain at least two bone anchoring elements and the rod-shaped elements that is used to connect bone anchoring element as described above, each bone anchoring element all is useful on the bone anchoring section that anchors into bone and accepts the bone screw that section, particularly bone anchoring element can be single shaft or multiaxis.
In addition, this invention relates to a kind of method of making rod-shaped elements, comprises following steps:
Prepare a rigid rod;
Preferably at least one vertical section in the free-ended preset distance of this bar, form the helical spring section with the method for removing material; And its core can axially get out or reserve; And/or elastic segments vertically on remove the material area that limits and produce non-circular cross sections with at least one zone in elastic segments, and/or the rigidity segment diameters is provided with lessly with respect to elastic segments.
This invention is particularly related to the flexible member that is used for bone or vertebra securing device; It roughly is one and contains the cylinder that first end reaches second end opposite with it; Said cylindrical opposite each end all contains in a coaxial aperture and these ends at least one end and contains female thread and be used to be connected to the nut and/or the screw rod of bone screw or be used to be connected to bar section or plate, and wherein particularly every end at two ends all has female thread.
This invention also relates to the flexible member that is used for bone and vertebra securing device; It roughly is a cylinder that contains first end and second end opposite with it, and said cylinder first end contains the nut or the screw rod that have externally threaded cylindrical outthrust and be used to be connected to bone screw, be used to be connected to the bar section perhaps is used to be connected to plate.
Said cylinder second end contains one and has nut or screw rod that externally threaded cylindrical outthrust is used to be connected to bone screw, is used to be connected to the bar section or is used to be connected to plate.
According to another preferred embodiment, said flexible member includes adjacent with second an end coaxial thorax hole and/or the section place adjacent with second end includes nut or screw rod that female thread is used to be connected to bone screw, is used to be connected to the bar section or is used to be connected to plate in coaxial thorax hole at least.
According to another preferred embodiment; The characteristic of said flexible member is that total length is run through in the thorax hole; And/or said cylinder is to have the tubulose in the coaxial thorax of seriality hole and have on the cylinder axis direction wall sunken inside that extends with spiral form, and wherein said depression terminates in place, thorax hole diametrically.
According to another preferred embodiment, the characteristic of said flexible member is to be provided with core in the thorax hole and/or flexible member forms coil spring.
According to another preferred embodiment, said flexible member with biocompatible materials particularly titanium process.
This invention is particularly related to the bone anchoring element that has like foregoing flexible member, and the dististyle that has comprised screw rod that has bone thread that is connected with flexible member one end and the bone screw that is connected with the flexible member other end is nut preferably.
This invention is particularly related to the rod-shaped elements that is used to connect two bone anchoring elements, and this rod-shaped elements has a flexible member and the first rigid rod section that links to each other with flexible member one end, wherein particularly has the second rigid rod section to link to each other with the flexible member other end.
This invention is particularly related to a kind of plate, and it has one to have externally threaded cylindrical outthrust or a thorax hole that has the female thread shape is arranged at the one of which end at least, is used to connect flexibility recited above or flexible member.
This invention is particularly related to a kind of securing device that is used for the dynamic stability of bone, osteogenic section or spinal column, has through interconnected at least two bone anchoring elements of foregoing rod-shaped elements.
This invention is particularly related to a kind of manufacture method of flexible member, comprises following step:
(a) prepare a tubular body or
(b) prepare a columniform object;
(c) form the spiral type depression through the method for removing material along the co-axial spiral type of main shaft of bearing of trend and cylinder or tubular body with the metal cutting mode from the outside;
(d) form a thorax hole along cylindrical main shaft;
(e) form female thread in two end section in tubular body or thorax hole;
Wherein the interior diameter in thorax hole is chosen to make the spiral type depression on the cylinder lateral wall that utilizes metal cutting formation in the step (c) to terminate in the thorax hole diametrically in the step (d), particularly in the another one end section in thorax hole, forms female thread.
This invention is particularly related to a kind of manufacture method of flexible member, comprises following step:
(a) prepare a cylinder;
(b) method each end formation at the cylinder two ends with the metal rotary cutting has externally threaded cylindrical outthrust;
(c) form the spiral type depression through the method for removing material along bearing of trend and the co-axial spiral type of cylinder main shaft with the metal cutting mode from the outside;
(d) form a thorax hole along the cylinder major axes orientation, particularly further comprising the steps of:
(f) afterbody that after forming the thorax hole, caves in through grinding polish spiral type is to remove the sharp edges on inboard, thorax hole; With
(g) the flexible member deburr for processing like this.
This invention is particularly related to a kind of manufacture method of flexible member, comprises following step:
(a) prepare a tubular body that has first and second ends;
(b) prepare cylinder and a formation and the co-axial thorax of cylindrical main shaft hole that has first and second ends, said thorax hole at least should be adjacent with cylinder first end;
(c) adopt line cutting edm, laser treatment or water cutter processing cutting to go out depression along bearing of trend and the co-axial spiral of cylinder main shaft;
(d) or cylindrical first end adopt the metal rotary cutting form a diameter less than step (a) in tubular body or (b) in the cylindrical outthrust of cylindrical predetermined outer diameter; And form external screw thread on this cylindrical outthrust surface; Perhaps in the thorax hole of contiguous cylinder or tubular body first end section, form female thread, wherein particularly the middle thorax hole that forms of step (b) extends to second end from cylindrical first end.
According to another preferred embodiment, this method also is included in the step that forms female thread in the thorax hole of contiguous cylinder second end section.
According to another preferred embodiment; Said method also comprises following step: at second end of cylinder or tubular body; Form the second cylindrical outthrust of diameter through the metal rotary cutting, and form external screw thread on this second cylindrical outthrust surface less than cylinder or the predetermined overall diameter of tubular body.
This invention is particularly related to a kind of manufacture method of flexible member, comprises following step:
(a) prepare a cylinder or a tubular body that has first end and second end;
(b) first end on cylinder and second end form the cylindrical outthrust of a diameter less than the predetermined overall diameter of cylinder in the step (a) or tubular body through the metal rotary cutting, and form external screw thread on this cylindrical outthrust surface; And
(c) along bearing of trend and the co-axial spiral of this cylinder main shaft, go out depression through line cutting edm, laser treatment or water cutter processing cutting, wherein particularly two afterbodys of spiral type depression are the form of 1/4 circle.
Description of drawings
Through below in conjunction with the detailed description of accompanying drawing to two specific embodiments, the further advantage of the present invention, characteristic and characteristic will become more obvious.The demonstration of accompanying drawing is schematic purely.
The 3-D view of the interval eyelid retractor of Fig. 1 vertebra or intervertebral disc;
The side view of the interval eyelid retractor among Fig. 2 Fig. 1;
The detailed side view of the interval eyelid retractor among Fig. 3 Fig. 1 and Fig. 2;
A)-c) the another kind of view of eyelid retractor at interval of Fig. 4;
Fig. 5 is the view of the third interval eyelid retractor a)-c);
Fig. 6 is the fabrication stage of object of the present invention a)-c);
Fig. 7 has two the pedicle screw devices of a connecting rod and the 3-D view of eyelid retractor at interval;
Fig. 8 is furnished with eyelid retractor at interval therebetween and carries out the 3-D view of side fixed adjacent vertebrae through the pedicle screw device of band flexible connecting rod;
The schematic three dimensional views that has the securing device of rod-like members among Fig. 9 the present invention;
The graphics of rod-like members among Figure 10 Fig. 9;
The side view of rod-like members among Figure 11 a Fig. 9;
The cutaway view of rod-like members among Figure 11 b Fig. 9;
The 3-D view that connects between Figure 12 a rod-like members and the bone anchor part;
The cutaway view that connects between Figure 12 b rod-like members and the bone anchor part;
The side view of the rod-like members among the another kind of embodiment of Figure 13;
The side view of the rod-like members among another embodiment of Figure 14;
Side view among Figure 15 Figure 14 behind rod-shaped elements rotation 90 degree;
The 3-D view of the rod-shaped elements among another embodiment of Figure 16;
The side view of rod-like members among Figure 17 Figure 16;
The cutaway view of the rod-like members among also a kind of embodiment of Figure 18;
Have the use of the securing device of a rod-like members among Figure 19 the present invention;
The side view of rod-like members among Figure 20 Figure 19;
The 3-D view of another kind of user mode that has the securing device of a rod-like members among Figure 21 Figure 19;
The side view of rod-like members among Figure 22 Figure 21;
The another kind of Figure 23 securing device is used;
Another applying examples of Figure 24 securing device;
The side view of another embodiment of Figure 25 a elasticity rod-like members;
The cutaway view of elasticity rod-like members among Figure 25 b Figure 25 a;
First kind of applying examples of Figure 26 a elasticity rod-like members;
The modification of rod-like members among Figure 26 b Figure 26 a;
Figure 27 has the bone anchor part of elasticity rod-like members among Figure 25 a and the 25b;
One of Figure 28 is by two three-member type bone anchor parts and the securing device that rod-like members is formed, and wherein each parts all comprises an elastomeric element;
The side view of another embodiment of Figure 29 elasticity rod-like members;
The side view of another embodiment of Figure 30 elasticity rod-like members;
Figure 31 a elasticity rod-like members is the side view of a kind of embodiment also;
The elasticity rod-like members is revolved the side view after turning 90 degrees among Figure 31 b Figure 31 a;
The cutaway view of Figure 32 elasticity rod-like members;
Elasticity rod-like members in Figure 33 further embodiment of this invention;
Elasticity rod-like members in Figure 34 yet another embodiment of the invention;
Figure 35 a comprises the exploded view of the bonded block of elastomeric element and a plate among a rod-like members, the present invention;
Plate among Figure 35 b Figure 35 a is along the cutaway view of A-A line;
The applying examples of plate among Figure 36 Figure 35 a and Figure 35 b, wherein said plate and the rod-like members that is connected to this plate through elastomeric element are anchored on the vertebra through the bone anchor part.
Figure 37 a elasticity rod-like members of the present invention is in the application of the dynamic securing device that is used for hipbone;
Figure 37 b is applied in the cutaway view of the bone anchor part on the securing device among Figure 37 a;
Cut edm, laser treatment or water cutter with line among Figure 38 the present invention and handle the spring members of processing.
The specific embodiment
Shown in Figure 1 is the three-dimensional representation of first kind of embodiment of an implant of the present invention, and this implant is used for vertebra or intervertebral disc as an interval eyelid retractor.At interval eyelid retractor 10 has a cylinder 1 and two links 2 that are positioned at this cylinder 1 end, and this link is used for being connected to its adjacent body area to an interval eyelid retractor 10, for example such as bone in the human body or cartilage.
The link 2 that in illustrated illustrative example, is arranged in cylinder 1 each end has same shape, but also can be different shapes.Link 2 has serration 3 on each free end of end, this projection can be at implantation position and adjacent body tissue tabling.
The serration 3 at eyelid retractor 10 two ends forms through triangular shaped recess 5 at interval, thereby makes chimeric being fixed in the adjacent body tissue of trapezoid serration 3 abilities.
In addition, link 2 has rhombus hollow out 4 (see figure 2)s, and is arranged to make them adjacent one another are at the whole cylinder outer surface of link 2.As a result, each link self forms through many rhombus interconnection moulding 6 again, and the rhombus end that forms of moulding 6 cuts away and formed trapezoid serration 3.
In illustrated embodiment, the tubular body 1 between the link 2 of each end of cylinder has spiral type material recess 7, so wall 11 (see figure 3)s itself form spiral type.Because eyelid retractor 10 forms hollow circular cylinder on the whole at interval; Even if so eyelid retractor 10 self is to be made up of original firm material such as titanium or titanium alloy at interval, the tubular body 1 that has material recess 7 between the link 2 becomes a Hookean region or zone of action.At interval eyelid retractor 10 has just obtained a kind of relevant elasticity that designs through material recess 7 in tubular body 1 zone, so just possibly need not in this zone, to use independent elastomeric material and obtains independent elasticity or activeness.Particularly, this can be avoided having to making eyelid retractor at interval with the parts that a plurality of needs are combined.
Through spiral type material recess 7, obtained easily tubular body 1 interval eyelid retractor 10 longitudinally ductility and the compressibility on the axis 9 and wind such as (Fig. 2) shown in the axis 8, perpendicular to the flexible on the rotating shaft of major axis 9.Here, particularly material recess 7 spiral-shaped brought into play effect, and it is convenient on the many directions of most probable, obtain the steadily elasticity or the activeness of even weighing apparatus.Yet nature can be expected and also can adopt the material recess of other shapes and this type material recess of varying number and arrangement according to solution that case adopted or possible loading condition.
The subgraph of Fig. 4 is a) to c) be that three the different figure of second kind of embodiment that have an interval eyelid retractor 100 of tubular body 101 are three-dimensional, exploded view (a), (c) and three-dimensional cross-sectional figure (b); This tubular body 101 is used at downside and is linked to be whole end plate 125 with tubular body 101 and seals, thereby forms a beaker shape.
Tubular body 101 has on its wall 111 and brings this tubular body 101 certain elastic helical forms depressions 107 according to the present invention.
In order accurately to adjust the at interval rigidity of eyelid retractor 100, a kind of interchangeable core components of being processed by elastomeric material 130 is provided in the inside of tubular body 101, this core components through end plate 125 from the bottom, end plate 126 is fixed on the tubular body 101 from top.
The end plate 126 of eyelid retractor upside has external screw thread 127 at interval, and it can be screwed into the female thread 128 of tubular body 101 inner top side place tubular bodies 101 through this external screw thread, and end plate 126 has a shoulder that it is tightly covered on wall 111.Thereby serration 103 be arranged on the whole circumference of wall 111 ends and stretched end plate 125 and end plate 126 can with the adjacent tissue tabling eyelid retractor can fixedly positioning at that so that make at interval.
Connecting hole 129 is arranged, so that can be screwed into end plate 126 in the tubular body 101 on the end plate 126.
Fig. 5 at subgraph a) to c) shown in be the third embodiment of interval eyelid retractor; Wherein subgraph a) and c) be three-dimensional, exploded view, and subgraph b) be depicted as three-dimensional cutaway view.In the embodiment of Fig. 5, tubular body 201 also has spiral type depression 207 on wall 211.
Tubular body 201 is also sealed by an end plate that is integrally formed 225 at the downside place, has formed the tubular body 201 of beaker dress so again.What really, the external diameter of end plate 225 was done than the tubular body 201 that wherein is provided with helical form material recess 207 is big.Therefore formed a shoulder, made the tubular sleeve of processing by elastomeric material 230 that an end seat arranged.Resilient sleeve 230 is enclosed within on the tubular body 201 also fully around it.In the upper end, end plate 226 is screwed on the tubular body 201 through being threaded.Here, the external screw thread 227 of end plate 226 and 228 engagements of the female thread of tubular body 201, thus sleeve 230 tightly is fixed between end plate 225 and the end plate 226.Sleeve 230 also is used to adjust whole rigidity, wherein changes sleeve 230 simply through being similar to the mode of changing core 130 (see figure 4)s, comes to change simply implant 100 and 200 whole rigidity.
End plate 225 and end plate 226 are provided with PYR serration 203 and are used for and surrounding tissue tabling and firm grappling interval eyelid retractor.
Lid 226 equally also has connecting hole 229, is used for end plate 226 is screwed on the tubular body 201.
Shown in Figure 6 is how laser beam 331 can form material recess 307 and 337 simply through laser treatment on pipe fitting 301 example.
A) visible from the subgraph of Fig. 6, and from plane graph, see obviously especially, at first drill pipe fitting 301 to form 332 and 333 two openings with laser beam 331; Then, like Fig. 6 b) shown in, in rotary tube piece 301, advance along the direction of arrow, just can form from the depression 307 of opening 332 beginnings and the depression 337 that begins from opening 333.The result has formed the parallel material recess of twice, is arranged to that mutual embedding contains, parallel, double pitch spiral spring or helical spring zone in pairs thereby formed.
Another embodiment for flexible implant among the present invention shown in Figure 7.Two the pedicle screw devices 12 and 14 that interconnect, have corresponding pedicle screw 13,15 through connecting rod 20 have been shown with graphics among Fig. 7.Connecting rod 20, saying so more accurately on the thronely is designed to flexible implant in FX 16, elasticity or 18 positions, zone of action between 17, and wherein connecting rod supports through the pedicle screw device.
Be provided with spiral type material recess 19 in the Hookean region 18 of connecting rod 20, this depression is extended around the longitudinal axis 21 of connecting rod 20.
Because connecting rod 20 is designed to hollow circular cylinder, Hookean region 18 is in fact also with regard to spirality.
In order to produce connecting rod of the present invention as shown in Figure 7, can use the solid cylindrical that constitutes by biocompatible materials such as titanium alloy or shaft-like.Primary step is in the specific region is Hookean region 18, perhaps in this solid hopkinson bar, to form material recess 19 through laser treatment through machining or chemical etching.This connecting rod will have bigger elasticity also can use like this at Hookean region 18.
On the longitudinal axis 21 of connecting rod 20, form the thorax hole and make connecting rod 20 form hollow circular cylinder shape or tubulose through machinery or chemical method, can further improve the elasticity or the activeness in zone 18.
The thickness that makes connecting rod wall that bar stays is less than the degree of depth of original material recess 19 that forms if the diameter in thorax hole is hanked, and in Hookean region 18, just is not groove depression but perforate so, and this is in fact also with regard to spirality.Though last-mentioned this shape is a preferred embodiment, the shape of before having mentioned that only has material recess be groove depression or other structure of ducted body also be can be used as alternative.
Shown in Figure 8 is the application of these two embodiment examples, promptly two vertebras 22, between 23 arrangement interval eyelid retractor 10 and at the pedicle screw device 12 on the human spine, flexible connecting rod 20 is set between 14.From this figure, can see easily that particularly under the situation of Combined application, the elastic construction of implant makes the spinal column respective regions have certain activeness, this will obviously increase patient's comfort.
Figure 19 to 38 has shown flexible implant, particularly the more embodiment and the range of application of the connecting rod in the spinal column securing device.
Visible from Fig. 9, shown in this securing device in using comprise a rod-like members 401 and through interconnective two pedicle screws 402,403 of this rod-like members.Pedicle screw 402,403 is anchored in the pedicle of vertebral arch of impaired two adjacent vertebraes 404,405 of intervertebral disc therebetween 406.
Rod-like members 401 among the present invention forms as one.According to first embodiment shown in Figure 10,11a and 11b; It comprises the first rigidity section 407 that begins, has predetermined length from rod-like members first end; Begin, have the second rigidity section 408 of predetermined length from second end of rod-like members; And at rigidity section 407, have the elastic segments 409 of predetermined length between 408, and the overall diameter of all sections is identical.In addition, rod-like members is run through in the coaxial thorax hole 410 that has a predetermined diameter.Elastic segments 409 forms a helical spring that has the screw thread 411 of predetermined pitch.The screw thread 411 of elastic segments 409 is chosen to make 411 pairs of rod-like members to have required rigidity receiving axial force, bending force, torsional forces along coaxial thorax hole 410 diameters of the height of rod-like members longitudinal axis A direction, decision screw thread 411 radial thickness and pitch.
Visible from Fig. 9,12a and 12b, the pedicle screw 402,403 of securing device has a screw rod 412 that has a bone thread and one to have to be used for inserting the U-shaped depression 415 of rod-like members, cylindrical end seat 413 basically as known.The built-in screw 414 that ability screw terminal seat is set as known is to be fixed on rigidity section 407,408 on the end seat 413.Pedicle screw is preferably processed multi-axial screws.The axial length of rod-like members 401 rigidity sections 407,408 and diameter are sized to the rod-like members 401 that has rigidity section 407,408 can be connected on the pedicle screw 402,403.So the length of rigidity section 407,408 is at least roughly suitable with the diameter of the built-in screw 414 that is used for fixing rod-like members.For the end seat 413 of pedicle screw 420 '; Because rod-like members is not to insert from top but laterally push at opening 421, so the length of rigidity section is also at least roughly suitable with the diameter at the built-in screw 414 of end seat 413 place's fixing shaft parts.
In the example of securing device shown in Figure 9, it is roughly suitable with the spacing of pedicle screw 402,403 under intervertebral disc 406 no-load conditions that the length of the elastic segments 409 of rod-like members 401 is chosen to, but but elastic segments 409 is also longer or shorter.
Rod-like members 401 is processed by biocompatible materials, and such as titanium or biocompatible plastic, yet this type material does not have or only have a little elasticity.
In operation process; At first pedicle screw 402,403,420 is screwed in the vertebra adjacent with pedicle of vertebral arch, then rod-like members 401 and rigidity section 407,408 thereof insert respectively the end seat (receiving-member) 413,413 of pedicle screw 402,403,420 ' one of in.Behind the relative position of the relative position of confirming vertebra 404,405 and adjustment pedicle screw 402,403,420 and rod-like members, with rigidity section 407,408 be fixed on end 413,413 ' in.The elastic segments 409 that the relative position of vertebra 404,405 is specified to rod-like members 401 is in relaxed state under intervertebral disc 406 no-load conditions.When load, stressed via acting on the intervertebral disc 406 behind vertebra and the intervertebral disc device.Rod-like members 401 has limited vertebra multiaxial motion each other through elastic segments 409, has avoided the excessive stressed of intervertebral disc thus.So just can prevent being worse off of slight or moderate defects intervertebral disc.Select as another kind, can under the spinal column no-load condition, carry out preset vertebra traction as required, to alleviate the intervertebral disc load by this method through securing device.As another selection, also can directly anchor into bone screw the vertebra from side direction as required.
In the embodiment shown in fig. 13; The same with the embodiment of front; A rod-like members 500 comprises 507,508 and elastic segments 590 that fuse with them, the helical spring form of rigidity section, and wherein elastic segments 590 is at rigidity section 507, between 508.What it was different with first embodiment is that the diameter of the diameter specific rigidity section 507,508 of elastic segments 590 is big.So, also the rigidity than rod-like members among first embodiment is big for the rigidity of acquisition.Described in operation process such as first embodiment.
Figure 14 and 15 is depicted as the rod-like members 501 among another embodiment.Different with rod-like members among the embodiment of front 401,500 is, is arranged on rigidity section 507, the elastic segments between 508 591 has two zones 592, and 180 degree and recessed to rod axis are departed from these two 592 zones mutually.The length L of zone 592 on the rod axis direction is the length of elastic segments 592 to the maximum, and radius of curvature is arranged to make helical spring screw thread to be unlikely to be interrupted.Thereby this structure of result make elastic segments 591 with the perpendicular direction of principal axis B of rod axis A on to form narrower waist rigidity on this direction less.It is favourable directed rigidity that the result just obtains to use for some.
Operation process such as previous embodiment situation are said, and unique rod-like members 501 that is not both can be connected in the pedicle screw with directed in a circumferential direction mode.Required rigidity can be selected, set to size through selecting elastic segments exactly.
Among Figure 16, the another embodiment shown in 17, rod-like members 502 has a concentric cylinder core 511 that runs through its elastic segments 593, and said core has certain elasticity of flexure.The diameter of core 511 is arranged to make core after pushing thorax hole 510, can block rightly and is fixed.Core preferably adopts and the rod-like members identical materials, but also can adopt elastoplast.
In a kind of design variable, core 511 is integral with helical spring being threaded to rigidity section 507,508 and elastic segments 593.
Compare with the embodiment of front, core 511 makes rod-like members 502 have bigger bending stiffness.So, in this embodiment, can obtain and have rod-like members 500 similar rigidity of bigger elastic segments diameter.Diameter and/or material chosen through core can further be adjusted bending stiffness.
Operation process carries out as under the embodiment situation of front.But different with front embodiment is, elastic segments 593 compression or extension and moment of torsion in the axial direction all diminishes dimensionally.Particularly only allow curvature movement, this uses for some is favourable.
In another kind of embodiment shown in Figure 180, rod-like members 503 before embodiment equally have 507,508 and elastic segments 590 of rigidity section.But in coaxial thorax hole 510, be provided with one and be fixed on tensile part 512 tinsel for example on the rigidity section 507,508 with tension through fixed part such as pinching screw 513.In operation, this can add prestressing force on elastic segments 590.
The technical characterictic of said each embodiment can mutually combine.Such as, rod-like members 501 also can have core and/or be used for obtaining directed inflexible given shape section.In the design variable of embodiment 502, elastic segments forms evenly narrower waist or uniform several sunk areas at interval is set on circumference a position, on the direction that limits, to obtain certain rigid.
In another embodiment, rod-like members have with if in individual elastic segments corresponding if in individual rigidity section, and each elastic segments is all between the rigidity section, makes many pedicle screws can both partially rigid partly flexibly interconnection.
In embodiment also, cover layer or the protectiveness overcoat of being processed by biocompatible materials is set around the elastic segments, with prevent to organize, blood vessel or other organism materials sandwich in the screw thread and cause damage injured or the rod-like members function.
And among another embodiment, adopt uni-axial screws to replace multi-axial screws, perhaps in securing device, use a uni-axial screws and the combination of a multi-axial screws or the combination of a plurality of these screws.Can expect equally replacing bone screw with hook.In another embodiment, rigidity section and/or elastic segments are crooked.
Figure 19 to 24 is depicted as several kinds of advantageous applications modes of the securing device that has rod-like members.In the securing device of Figure 19 to 22, use the rod-like members 502 that has core 511.This securing device is used for supporting and need avoid the illeffects masterpiece to be used on the intervertebral disc through the activity of restriction vertebra the time such as intervertebral disc 506 needs of slight or moderate defects.Rod-like members 502 is inflexible in the axial direction, neither allows to elongate or also do not allow compression in the axial direction.But being the α angle with the bar axle is fine such as the curvature movement that are 8 degree to the maximum.
Shown in Figure 23 for the securing device that has a rod-like members after taking primary intervertebral disc away with rigid element 450 such as the application in the situation of two vertebras 404,405 of titanium cylinder connection.Here, bar needs bigger rigidity so that can obtain enough motion restrictions.But be connected with perfect rigidity and compare, interpyramidal slight relative motion is good; Because increasing the circulation partial load can stimulate bone tissue growth and quicken ossific process.
The application of the elastic ends that to be dynamic securing device connect as expansion that shows among Figure 24, wherein several in illustrative example be 3 vertebras 405,405 ', 405 " interconnect and subsequently with rigid rod 460 connections through rigid element 450.Here, having born disproportionate load with the last vertebra of connection chain 405 and next piece vertebra 404 adjacent primary intervertebral disc 406 causes intervertebral disc 406 wearing and tearing to increase.For the load of protecting this adjacent part to avoid improper motion and increase thus, securing device is used for constrained motion.In the embodiment that this gives an example, rod-like members 460 have be dimensioned to make three pedicle screws 402,402 ', 402 " the rigidity sections 458 that can be attached thereto.Elastic segments 459 is arranged to be adjacent and is connect, and it is adjacent to be used to link the rigidity section 457 of pedicle screw 403 end and one again.
In the manufacturing approach of rod-like members of the present invention, be ready to constitute, have such as titanium the rigid rod of required diameter with the body compatibility material.Be processed into the elastic segments 409 of helical spring form then in the section between each end of rod-like members.If desired, bore and remove to run through the core 410 in the spring members, thereby form rod-like members 401.
When making rod-like members 502, core 511 stays or inserts subsequently another independent core.
When making rod-like members 500, prepare bar that what a diameter meets elastic segments 590 diameter requirements, adopt the method for for example miller to process helical spring then, become required diameter to rigid end section 507,508 cars again as raw material.
Be to make rod-like members 501, on elastic segments, along the circumferential direction depart from mutually in the zone of position of 180 degree and remove material so that form directed waist thus.
In first example application shown in Figure 26, spring members 601 is one ingredients of elasticity rod-like members 630.Elasticity rod-like members 630 comprise an elastomeric element 601 and two cylindrical bar sections 631,631 '; Each bar section 631 and 631 ' end respectively have a cylindrical outthrust 632,632 ', have respectively on these two outthrust can with the external screw thread 633,633 of female thread 604,604 on the elastomeric element 601 ' cooperate '.In this embodiment, rod-like members and elastomeric element have essentially identical diameter.Rod-like members 631,631 ' and spring members 601 can independently select length separately according to required application.For example, rod-like members is used to connect epispinal pedicle screw.Because the elasticity of spring members 601, the rod-like members of processing according to this 630 absorbs compression stress, tension force, bending force and twisting resistance to predetermined degree.
Elasticity rod-like members 680 shown in Figure 26 b is with the difference of elasticity rod-like members 630, the overall diameter of its first rigid rod section 681 than the big of elastomeric element 601 and second rigid rod section 681 ' overall diameter little than elastomeric element 601.Select as another kind, the diameter of two bar sections can be all greater than or all less than spring members.
Shown in Figure 27 is second application example of elastomeric element 601.Can find out that on scheming elastomeric element 601 is one ingredients being arranged to the bone anchor part 610 of multiaxis bone screw form.This multiaxis bone screw comprise one by elastomeric element 601, have the screw rod 612 at unshowned tip and the screw component 611 that nut 613 is formed here.
The cylindrical outthrust 626 that nut 613 comprises cylindrical outthrust 627 and is adjacent, with similar in the screw rod 612, cylindrical outthrust 626 have with elastomeric element 601 on the external screw thread of female thread 604 ' be used.
In addition; In acceptor site 614, also have a press member 621 to be used for fixing nut 613; This press member 621 is designed in the side towards nut 613 bulb-shaped recess 622 is arranged, and the radius of this bulb-shaped recess 622 is substantially equal to the radius of the billiard table shape section of nut 613.The overall diameter of press member 621 is chosen to make press member 621 to insert in the acceptor site 614 in nut 613 directions.In addition, also have a coaxial thorax hole 623 on the press member 621, engage with depression (figure is last not to be drawn) on the nut 613 so that the screw-in instrument can be stretched into.
In operation process, screw rod 612 screws in the female thread 604 of elastomeric elements 601 through the cylindrical outthrust on it 625, and nut 613 through its cylindrical outthrust 626 screw in female threads 604 ', so just formed screw component 611.Screw rod 612 forward, with the screw component of processing according to this 611 through second perforate insert acceptor site 614 up to the edge in the nut 613 and the first thorax hole 615 near.Then, press member 621 gets into acceptor site 614 through the second thorax hole 616 forward with bulb-shaped recess.Then screw component 611 is screwed in bone or vertebra.At last, bar 620 is placed two lower limbs 617, acceptor site 614 between 618, the adjustment acceptor site is fixed with respect to the angle position of screw component and with built-in screw 619.Elastic segments allows near the limited activity relaxed position.
Multi-axial screws is not limited to the embodiment of above description, and can be the multi-axial screws of any other said syllogic screw component above band.Correspondingly; If in the operation before elastomeric element 601 and screw rod 612 screw in nuts 613 earlier nut 613 with cylindrical outthrust 626 forward through the second thorax hole, 616 entering acceptor sites 614, what the diameter in the first thorax hole 615 among the embodiment then shown in Figure 27 can be than screw rod 612 is little.In such cases, as long as the first thorax hole, 615 diameters greatly just much of that than cylindrical outthrust 626 and cylindrical sector 627.Select as another kind, nut 613 can not have cylindrical sector 627 yet.In the case, the diameter in the first thorax hole only need be enough to let outthrust 626 through getting final product.
But acceptor site also can be designed to from following insertion screw component and through a press member screw component is clipped in the middle of the acceptor site.In this case, the diameter in thorax hole 615 shown in Figure 27 should be bigger than the diameter of nut 613.
Bar fixedly be not limited to built-in screw shown in Figure 27, and can use the bar fixing means of additional external nut or other any known types.
If elastomeric element 601 can partly protrude in bone surface at least, elastomeric element 601 just can absorb bending force and tension force and pressure so.When spring members did not protrude in bone surperficial, screw component 611 still can be reacted to the motion of bone or vertebra in a certain way.This has stoped the development of disadvantageous tense situation.
Shown in Figure 28 is the securing device 690 of spinal column; Comprising two bone anchor parts 691,691 that have a screw component 693 ' with the elasticity rod-like members 692 that is used to be connected two bone anchor parts, these elasticity rod-like members 692 have elastomeric element 601 of the present invention.This multi-piece type design of elasticity rod-like members and screw component allows a securing device 690 that obtains to have various characteristics with the combination of some basic elements of character.This securing device also not necessarily must comprise the bone anchor part of being with elastomeric element and the bar type parts that have elastomeric element.According to the field of using, also can only comprise bar type parts that have spring members and the bone anchor part that has the rigidity screw component.
Shown in Figure 29 is elastomeric element 640, the difference of elastomeric element 640 and elastomeric element 601 only be female thread 641 that length has run through the elastomeric element total length replaced two female threads 604,604 '.
Shown in Figure 30 is elastomeric element 650.These parts comprise rigid tip part 651 and 651 that different with aforesaid embodiment is ' and compare the less spiral number of turns with the embodiment of front.This can make the elastic design of spring members be independent of the length of spring members.
Figure 31 a and 31b are depicted as spring members 660, and be different with aforesaid embodiment, and it comprises two zones 661, and 180 degree and all recessed to central shaft are departed from these two zones each other.Zone 661 length L ' be not more than the length L of spiral at central axis direction, and the radius of curvature in zone 661 is arranged to be unlikely to make helical spring bung flange to interrupt.Because this design, this spring members with the perpendicular direction of central shaft on a narrower lumbar shape is arranged, therefore rigidity is less on this direction.This makes the rigidity of elastomeric element that directivity arranged, to be fit to the needs of some application.
Shown in Figure 34 is spring members 770, and its each end has one to have externally threaded cylindrical outthrust 771,772 respectively.
As a kind of modification of previous embodiment, elastomeric element does not comprise successive thorax hole.
As another example application of elastomeric element 601 of the present invention, shown in Figure 35 a in the exploded view is link 700, and this link contains rod-shaped member 631, elastomeric element 601 and plate 701.A column type outthrust 632 that has external screw thread 633 is arranged on the rod-shaped member 631, and this external screw thread is used to screw near the female thread 604 of elastomeric element 601 1 ends.Plate 701 also includes the column type outthrust 702 that has external screw thread 703, this external screw thread be used to screw in be positioned at elastomeric element 601 an other end near female thread 604 '.This plate comprise two sections 704 and 704 ', this two section is rounded and link to each other each other through fin 705 in vertical view.The width B of fin 705 less than circular section 704,704 ' diameter D.Be used to place the thorax hole 706,706 that two of counter-sunk screw pass plate ' be arranged to circular section coaxial.Shown in Figure 35 b, first 707 of plate has bending and second 708 bending that depression is arranged of plate of a convexity, and the bending of this depression is to be used to make this face near bone.The different curvature radius of two faces 707,708 of plate 701 causes plate 701 towards the attenuation gradually of side 709 directions.This makes plate not only stable but also save the space.Shown in Figure 35 b, thorax hole 706,706 ' respectively comprises hole 706a, the taper first section 706b and the second section 706c; Second 708 of its mesopore 706a adjoining plate, contiguous this hole of the taper first section 706b, contiguous first section of the second section 706c and plate first 707.Their shape makes thorax hole 706 and 706 ' be fit to accept counter-sunk screw.Thorax hole 706 and 706 ' shape can be with above-described different, as long as they are fit to accept counter-sunk screw.
Shown in Figure 36 is an application example of the link among Figure 35 a.Wherein plate 701 is fixed in two vertebras 711 that are positioned at the cervical part of esophagus spinal column through two bone screw 710 from rear side, and the rod-shaped member 631 of linking this plate 701 through elastomeric element 601 is anchored on the vertebra 712 of breast section spinal column through three bone anchoring screw parts 715.
Shown in Figure 37 a is that spring members 601 among the present invention is used in another application example in the dynamic pelvis securing device 730.This dynamic pelvis securing device comprise through rod-shaped member 631,631 ' and 631 " with spring members 601 and 601 " interconnective bone anchor part 728,728 ' and 728 ".
With other two bone anchor parts 728 ' with 728 " the same; that bone anchor part 728 comprises two and half ones 725 and 731; that this two and half one is connected with each other through a screw 727, screw thread 735 engagements in screw thread 734 in screw 727 and the first half ones 725 and the second half ones 731.Half one 725 above vertical view in Figure 37 a only shows.Rod-shaped member 631 is clipped in two and half ones 725 noted earlier, between 731, and in the depression 732 in the first half ones 725 and in the depression 733 in the second half ones 731, so just bone anchor part 728 is connected on the rod-shaped member 631 securely.In addition, two and half ones 725,731 have thorax hole 736,737 respectively, these two thorax hole arranged in co-axial alignment under the state of assembling.Near the thorax hole 736 bulb-shaped recess 738 is used for hold bone screw 726 with near thorax hole 737 bulb-shaped recess 739.Bone screw 726 comprises the nut section 753 of a rod section 751 and a billiard table shape, has the external screw thread 752 that is used to screw in bone on its king-rod type section 751, and the radius of billiard table shape nut 753 equates with the radius of bulb-shaped recess 738 and 739 basically.
Similar with the bone anchor part, link 724 also has two and half ones 722, in the vertical view of Figure 37 a, can only see one.Through getting into depression, rod-shaped member 631 is clipped in foregoing two and half ones 722, thereby link 724 is firmly received on the rod-shaped member 631 mutually.
Rod unit 721 comprises a ballhead section 721b and a bar section 721a.Thereby head sections 721b is clamped to link to each other with two and half ones 722 by the depression between unshowned, two and half ones 722 and makes it be fixed in a pivot location.Another end opposite with head 721b is rod-like members 721a, and it comprises that has an externally threaded column type outthrust (not shown), wherein external screw thread can screw in elastomeric element 601 ' in the female thread (not shown).
The method of the available miller of making of elastomeric element; Its used raw material is the cylinder that is constituted, had predetermined overall diameter by material with biocompatibility such as titanium, uses the thin slice milling cutter to mill out depression along its main shaft and the collinear helix of cylindrical main shaft then.Subsequently, form the thorax hole along cylindrical main shaft, the cylinder total length is run through in this hole, and the spiral type depression is terminated on the thorax hole.In order to guarantee the stability of elastomeric element, the spiral afterbody of transition is very important between the distolateral section of spiral part and elastomeric element.Therefore be necessary to use slotting cutter finishing spiral afterbody, to remove inner sharp keen edge, thorax hole at the both ends of spiral.In order to reach this purpose, the spiral afterbody uses slotting cutter to carry out milling along the tangential direction of spiral profile.Subsequently, with the interior outside burr removing of whole assembly.At last, produce female thread respectively in two end section in thorax hole.
Except using the milling technology, elastomeric element 800 also can use line cutting edm, laser treatment or water cutter to handle and processed by cylinder.Shown in figure 38, processing also can form a thorax hole 801 of running through the cylinder total length along cylindrical main shaft A since a cylinder that predetermined overall diameter D ' is arranged in step subsequently.Select above-mentioned a kind of processing method according to the thickness of wall subsequently, cut the hollow circuit cylinder body wall of processing according to this along spiral 802.The afterbody 803 of spiral 802 forms the shape of one 1/4 circle, becomes unnecessary thereby make with respect to accomplishing afterbody 803 through extra procedure in the milling operation.And, also need not deburr in these operations.The shape of afterbody also needn't be 1/4 circle, can be the shape of any other shape such as another section of circle, as long as make material maximum load in use can remain on low level through these shapes.
At last, as the processing technology that adopts miller, two end section form female thread separately in the thorax hole.
In a kind of improved form, said method can be changed into when operation begins, to get on the bus at lathe and has externally threaded cylindrical outthrust and replace at least one female thread.In this situation, the diameter in thorax hole must be less than the diameter of cylindrical outthrust.
In the improvement manufacturing process of another, spring members is made into does not have successive thorax hole.
Claims (29)
1. spinal column securing device, it comprises:
First bone anchoring element, it is used to anchor into vertebra, and said first bone anchoring element has the first end seat;
Second bone anchoring element, it is used to anchor into vertebra, and said second bone anchoring element has the second end seat; And
Link is contained in said first end seat and the said second end seat through making said link, and said link is set to said first bone anchoring element is connected to said second bone anchoring element, and said link comprises:
First rigid portion, it has the first rigid tubular body, and the said first rigid tubular body is set to be connected to said first bone anchoring element;
Second rigid portion, it has the second rigid tubular body, and the said second rigid tubular body is set to be connected to said second bone anchoring element; And
Elastic, it has the elastic tubular body of band spiral depression, and said elastic tubular body is arranged as between said first rigid portion and said second rigid portion, wherein,
Said spinal column securing device comprises also and is used for substituting the intervertebral disc adjacent with said link or the interval eyelid retractor of vertebra that said interval supporter has tubular body, and said tubular body has the elastic segments of band spiral depression.
2. spinal column securing device according to claim 1 is characterized in that, at least a portion in the said spinal column securing device is made into integration with a kind of material.
3. spinal column securing device according to claim 1 and 2 is characterized in that, the zone that forms said spiral depression connects the joint as compression or drawing zone, torsional zones and/or conduct.
4. spinal column securing device according to claim 3 is characterized in that, the zone of the said spiral depression of said formation and other zones of said spinal column securing device link into an integrated entity.
5. spinal column securing device according to claim 1 and 2 is characterized in that, said spinal column securing device comprises at least a biocompatible materials, and said biocompatible materials is inflexible.
6. spinal column securing device according to claim 5 is characterized in that, said biocompatible materials is the material that under the application-specific condition, has flexural rigidity.
7. spinal column securing device according to claim 5 is characterized in that, said biocompatible materials is selected from the group of titanium and alloy and plastics composition.
8. spinal column securing device according to claim 1 and 2 is characterized in that, said spiral is recessed to form and is the perforate of wall and/or groove-like depression.
9. spinal column securing device according to claim 1 and 2 is characterized in that, two said spirals are recessed to form to a kind of mutual embedding contains, the groove-like depression and/or the perforate of parallel helical in pairs.
10. spinal column securing device according to claim 1 and 2; It is characterized in that; Said spinal column securing device comprises the part of being processed by elastomeric material; This part is used for obtaining elasticity with the part that has the spiral depression, makes last rigidity of whole spinal column securing device or activeness be able to confirm.
11. spinal column securing device according to claim 10 is characterized in that said elastomeric material is an elastomer.
12. spinal column securing device according to claim 1 and 2 is characterized in that, said interval eyelid retractor (10) have support at interval with the weight forwarding function as premiere feature, and/or said link has support and linkage function as premiere feature.
13. spinal column securing device according to claim 1 and 2; It is characterized in that; The end of said tubular body is useful on the connecting device (2) that partly links to each other with adjacent body part or other spinal column securing device, and the depression of the spiral on the said tubular body make said spinal column securing device compressible in the axial direction with stretch and can and can reverse around rotating shaft (13) bending radially around axial rotating shaft for the connecting device (2) of end.
14. spinal column securing device according to claim 13 is characterized in that, said tubular body is used the sleeve that is made up of the biocompatible flexible material to encase and/or is had the core that is made up of the biocompatible flexible material.
15. spinal column securing device according to claim 14 is characterized in that said sleeve and/or core are fixed by the end plate that is arranged on the said tubular body integratedly or separably.
16. spinal column securing device according to claim 15 is characterized in that, said sleeve and/or core are fixed by the end plate that is connected separably on the said tubular body through screw or screw thread.
17., it is characterized in that said elastomeric material is an elastomer according to claim 14 or 15 described spinal column securing devices.
18. spinal column securing device according to claim 1 and 2 is characterized in that, said interval eyelid retractor and/or said link, and with regard to it is vertical, but elastic stretching or elastic compression 0.5% to 20%.
19. spinal column securing device according to claim 18 is characterized in that, said interval eyelid retractor and/or said link, and with regard to it is vertical, but elastic stretching or elastic compression 1% to 15%.
20. spinal column securing device according to claim 1 and 2 is characterized in that, said tubular body, and with regard to it is vertical, but elastic stretching or elastic compression 0.5% to 20%.
21. spinal column securing device according to claim 20 is characterized in that, said tubular body, and with regard to it is vertical, but elastic stretching or elastic compression 1% to 15%.
22. spinal column securing device according to claim 1 and 2; It is characterized in that; Said interval eyelid retractor and/or said link can elastic bendings on radial axle, make the connecting device (2) that is used for partly linking to each other with adjacent body part or other spinal column securing device that is located at the tubular body end can be with respect to 0.5 ° to 10 ° of the longitudinal axis (12) deflection of tubular body.
23. spinal column securing device according to claim 22; It is characterized in that; Said interval eyelid retractor and/or said link can elastic bendings on radial axle, make the connecting device (2) that is used for partly linking to each other with adjacent body part or other spinal column securing device that is located at the tubular body end can be with respect to 1 ° to 6 ° of the longitudinal axis (12) deflection of tubular body.
24. spinal column securing device according to claim 1 and 2; It is characterized in that; Said tubular body can elastic bending on radial axle, makes the connecting device (2) that is used for partly linking to each other with adjacent body part or other spinal column securing device that is located at the tubular body end can be with respect to 0.5 ° to 10 ° of the longitudinal axis (12) deflection of tubular body.
25. spinal column securing device according to claim 24; It is characterized in that; Said tubular body can elastic bending on radial axle, makes the connecting device (2) that is used for partly linking to each other with adjacent body part or other spinal column securing device that is located at the tubular body end can be with respect to 1 ° to 6 ° of the longitudinal axis (12) deflection of tubular body.
26. spinal column securing device according to claim 1 and 2 is characterized in that, said interval eyelid retractor and/or said link can reverse 0.5 ° to 10 ° around its axial axis.
27. spinal column securing device according to claim 26 is characterized in that, said interval eyelid retractor and/or said link can reverse 1 ° to 6 ° around its axial axis.
28. spinal column securing device according to claim 1 and 2 is characterized in that, said tubular body can reverse 0.5 ° to 10 ° around its axial axis.
29. spinal column securing device according to claim 28 is characterized in that, said tubular body can reverse 1 ° to 6 ° around its axial axis.
Applications Claiming Priority (11)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US51211303P | 2003-10-17 | 2003-10-17 | |
| DE10348329.2 | 2003-10-17 | ||
| US60/512,113 | 2003-10-17 | ||
| DE10348329A DE10348329B3 (en) | 2003-10-17 | 2003-10-17 | Rod-shaped element used in spinal column and accident surgery for connecting two bone-anchoring elements comprises a rigid section and an elastic section that are made in one piece |
| US52394603P | 2003-11-21 | 2003-11-21 | |
| US60/523,946 | 2003-11-21 | ||
| US55018204P | 2004-03-03 | 2004-03-03 | |
| US60/550,182 | 2004-03-03 | ||
| DE102004021861.7 | 2004-05-04 | ||
| DE102004021861A DE102004021861A1 (en) | 2004-05-04 | 2004-05-04 | Implant for temporary or permanent replacement of vertebra or intervertebral disk, comprising solid central element and outer elements with openings |
| PCT/EP2004/011782 WO2005039454A2 (en) | 2003-10-17 | 2004-10-18 | Flexible implant |
Related Child Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN200910163700.1A Division CN101647734B (en) | 2003-10-17 | 2004-10-18 | Flexible implant |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1870952A CN1870952A (en) | 2006-11-29 |
| CN1870952B true CN1870952B (en) | 2012-07-18 |
Family
ID=37444412
Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN200910163700.1A Expired - Fee Related CN101647734B (en) | 2003-10-17 | 2004-10-18 | Flexible implant |
| CN2004800305254A Expired - Fee Related CN1870952B (en) | 2003-10-17 | 2004-10-18 | Flexible implant |
Family Applications Before (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN200910163700.1A Expired - Fee Related CN101647734B (en) | 2003-10-17 | 2004-10-18 | Flexible implant |
Country Status (1)
| Country | Link |
|---|---|
| CN (2) | CN101647734B (en) |
Families Citing this family (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| KR100837108B1 (en) * | 2008-01-11 | 2008-06-11 | 최길운 | Flexible rod for fixation of the vertebrae |
| EP2618785B1 (en) | 2010-09-20 | 2016-06-01 | Synthes GmbH | Compliant implant |
| CN106361419B (en) * | 2014-10-24 | 2019-07-19 | 郑金玲 | A kind of exter-nal fixer being suitable for comminuted fracture |
| CN105078623B (en) * | 2015-09-02 | 2017-03-22 | 李志忠 | Biological self-locking artificial intervertebral disk system and application thereof |
| CN108236518A (en) * | 2016-12-23 | 2018-07-03 | 重庆润泽医药有限公司 | Operation tantalum bar device |
| CN106943215A (en) * | 2017-04-25 | 2017-07-14 | 中国人民解放军第二军医大学第二附属医院 | A kind of adjustable assembly type artificial vertebral body |
| CN109481090A (en) * | 2017-09-13 | 2019-03-19 | 重庆润泽医药有限公司 | Porous tantalum tantalum stick |
| CN107961065B (en) * | 2018-01-09 | 2020-09-11 | 绍兴市人民医院 | Orthopedic implant |
| CN113413255B (en) * | 2021-08-24 | 2021-11-16 | 南通欣昌减震器有限公司 | Blood vessel supporting rubber stent |
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| US5423816A (en) * | 1993-07-29 | 1995-06-13 | Lin; Chih I. | Intervertebral locking device |
| US5423817A (en) * | 1993-07-29 | 1995-06-13 | Lin; Chih-I | Intervertebral fusing device |
| FR2717370A1 (en) * | 1994-03-18 | 1995-09-22 | Moreau Patrice | Intervertebral stabilising prosthesis for spinal reinforcement inserted during spinal surgery |
| EP0950389A2 (en) * | 1998-04-16 | 1999-10-20 | Aesculap AG & Co. KG | Intervertebral fusion implant |
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| FR2634371A1 (en) * | 1988-07-21 | 1990-01-26 | Flegeau Gerard | Hip prosthesis and method for manufacturing such a prosthesis |
| US5423816A (en) * | 1993-07-29 | 1995-06-13 | Lin; Chih I. | Intervertebral locking device |
| US5423817A (en) * | 1993-07-29 | 1995-06-13 | Lin; Chih-I | Intervertebral fusing device |
| FR2717370A1 (en) * | 1994-03-18 | 1995-09-22 | Moreau Patrice | Intervertebral stabilising prosthesis for spinal reinforcement inserted during spinal surgery |
| EP0950389A2 (en) * | 1998-04-16 | 1999-10-20 | Aesculap AG & Co. KG | Intervertebral fusion implant |
Also Published As
| Publication number | Publication date |
|---|---|
| CN101647734A (en) | 2010-02-17 |
| CN1870952A (en) | 2006-11-29 |
| CN101647734B (en) | 2014-05-07 |
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