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CN103687575A - 椎间设备和使用方法 - Google Patents

椎间设备和使用方法 Download PDF

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Publication number
CN103687575A
CN103687575A CN201180056812.2A CN201180056812A CN103687575A CN 103687575 A CN103687575 A CN 103687575A CN 201180056812 A CN201180056812 A CN 201180056812A CN 103687575 A CN103687575 A CN 103687575A
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China
Prior art keywords
intervertebral device
strut
intervertebral
struts
adjacent
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CN201180056812.2A
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CN103687575B (zh
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摩根·P·洛里奥
托马斯·珀塞尔
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EIT Emerging Implant Technologies GmbH
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Individual
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    • 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
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    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • 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 or setting implements
    • 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, e.g. stabilisers comprising fluid filler in an implant
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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Prostheses (AREA)

Abstract

一种椎间装置，该装置包括多个支柱，其中每一个相邻支柱与每一个相邻的支柱可旋转地关联，从而当所述椎间装置处于展开状态时为骨移植容器形成可变内部体积V，由此所述内部体积V由所述多个支柱围绕。

Description

椎间设备和使用方法
相关申请的交叉参考
本申请要求2010年10月5日在美国提交的第61/389,862号美国临时专利申请的优先权，其通过引证的方式并入本文。
相关申请
本申请涉及于2011年9月29日在美国提交的第13/248,747号美国专利申请，发明名称为“Minimally Invasive Intervertebral Systemsand Methods（最小侵入椎间的系统和方法）”，其通过引证的方式并入本文。
技术领域
本发明一般涉及用来治疗椎间损伤的设备，更具体地，涉及最小侵入椎间的植入物。
背景技术
椎骨是组成弯曲且弹性的脊柱（又叫做坐骨）的单独的不规则骨。人类通常有33节椎骨，包括融合形成骶骨的5节椎骨（其它的椎骨被椎间盘分隔开）和4节形成尾椎骨的尾骨。上部3个区域包括其余的24节椎骨，并且根据它们所在的区域被分组为颈椎（7节椎骨）、胸椎（12节椎骨）和腰椎（5节椎骨）。这个数字有时被一个区域中的额外椎骨增加，或在一个区域中减小，缺少的椎骨通常由在另一个区域中的其它椎骨提供。但是，颈椎椎骨的数量很少增加或减少。
典型的椎骨由两个基本部分组成：前段，其是椎体；和后部—椎（神经）弓—其围绕椎孔。椎弓是由一对椎弓根和一对薄片形成，并且支承7个突起、4个关节、2个横肌、和1个棘，最后一个还被公知为神经棘。
当椎骨彼此铰接，身体形成牢固的柱用来支承头和躯干，并且椎孔组成管用来保护棘肌髓（脊髓），而在每一对椎骨间有两个孔，即椎孔，一侧一个，用来传送脊神经和血管。
在脊柱融合术中使用传统的脊骨垫片组件来修复损伤的或未正确铰接的椎骨。脊柱融合术采用具有中空网眼的间隔管和端盖的垫片组件将相邻的椎骨分隔开以及融合在一起。这些网眼间隔管通常由钛形成，并且具有各种形状和尺寸。此外，它们可以在现场被外科医生修剪，从而针对每一个患者提供更好的单独匹配。传统的脊骨垫片组件具有不同的横截面。这些垫片组件通常是中空的，并且在其侧包括开口从而在网眼管内为骨生长和融合提供通道。目前，使用三个主要原则设计椎间或椎间体设备：外科手术方法的解剖限制，促进骨融合的骨移植体积的最优化，以及与椎体终板相接触从而抵制下沉的装置最优化。目前的装置基本是静止的，它们不能改变形状或体积，因此，当前装置被解剖学和技术所限制，因此不能提供最佳的骨移植体积或表面接触。本发明试图解决这些问题和其它问题。
发明内容
本文提供了用于椎间设备的系统、方法和装置。椎间设备通常包括多个支柱，其中每一个相邻的支柱与每一个相邻的支柱可旋转地关联，从而当所述椎间设备处于展开状态时为骨移植包含（containment）形成可变内部体积V，由此所述内部体积V被多个支柱围绕。
使用椎间设备的方法通常包括以下步骤：通过移除环的一部分，撤出核，且然后移除软骨终板来准备椎间隙；围绕所述椎间设备的横轴线旋转所述椎间设备，并且将椎间盘以椎间设备的宽度TT平行于椎骨终板的方式放置在椎间隙中；围绕椎间设备的横轴线旋转椎间设备90度从而增加所述椎间隙的高度；展开所述椎间设备从而增加包围在多个支柱内的内部体积V，使得所述椎间设备打开；并且用骨移植材料填充所述内部体积V，从而允许在相邻的椎骨间的骨融合。
所述方法、系统和装置部分在下面的说明书中被提出，部分将从说明书中显而易见，或可以通过实施系统、方法和装置而被得知。系统、方法和装置的优点将通过在随附权利要求书中特别指出的元素和组合被实现和获得。应理解，以上一般描述和以下详细描述仅是示意性和说明性的，并且不限制本发明要求保护的系统、方法和装置。
附图说明
在附图中，相同的元件在本发明的各个优选实施方式中用相同的标号表示。
图1A是椎间设备的一个实施方式在展开状态下的立体图；图1B是椎间设备的一个实施方式沿图1中的1B-1B线的侧视图；并且图1C是椎间设备的一个实施方式在闭合状态或内部体积V基本为零的立体图。
图2A是支柱的一个实施方式的立体图；图2B是支柱的一个实施方式沿图2A的2B-2B线的俯视图；图2C是支柱的一个另选实施方式的立体图；以及图2D是支柱的一个另选实施方式的立体图。
图3是相邻的支柱以及在可旋转关联的支柱之间的角A的一个实施方式的立体图。
图4A是在闭合状态或内部体积V基本为零的椎间设备的一个实施方式的立体图；图4B是处于闭合状态具有基本为零的内部体积V的椎间设备沿图4A中的4B-4B线的俯视图；以及图4C是具有锁定机构的椎间设备在展开状态的俯视图。
图5是椎间设备的一个另选实施方式的立体图。
图6A是椎间设备和椎骨的立体图，其中椎间设备正围绕其横轴旋转地被输送到椎间隙；图6B是椎间设备和椎骨的立体图，其中当位于椎间隙内时椎间设备围绕其横轴线转；以及图6C是椎间设备和椎骨的立体图，其中当针对骨填充包含设置在椎间隙内时，椎间设备以内部体积V展开。
图7是针对使用椎间设备的方法的示意图。
结合附图，本发明的上述和其它特征和优点从示意性实施方式的以下详细说明将显而易见，其中相同的结构或功能元件可以由相同的标号指定。
具体实施方式
结合附图，本发明的上述和其它特征和优点从示意性实施方式的以下详细说明将显而易见。详细说明和附图仅是例示性的而不限制本发明，本发明的范围由随附权利要求书及其等同物限定。
总地来说，椎间设备100包括多个支柱120，它们与每一个相邻的支柱120可旋转地关联，从而形成用于骨移植包含的可变内部体积V，如图1A所示。椎间设备100包括展开状态，由此内部体积V被多个支柱120围绕。椎间设备100通常包括从椎间设备100的近端部110至远端部112的纵轴线102。椎间设备100通常包括一般从左部114至右部116的横轴线104。多个支柱210与每一个相邻的支柱120可旋转地关联并且通常沿至少纵轴线102和/或横轴线104旋转展开或接触可变内部体积V。椎间设备100包括前—后轴线106，该前-后轴线106通常从前表面108至后表面118，如图1B所示。当椎间设备100处于展开状态时，可变内部体积V通常从前表面108延伸至后表面118。可变内部体积V为在椎间设备100的前表面108和后表面118上的相邻椎骨提供最佳骨移植体积和表面接触区域。当处于展开状态时，多个支柱120相对于相邻的支柱120优选地是静止的。在一个实施方式中，骨移植材料被放置在内部体积V中，骨移植将在椎间设备100上产生向外的力，因此椎间设备不会倒塌或变形为非展开或闭合状态。
椎间设备100可以包括任何数量的支柱120，该支柱120可以通过一般沿着纵轴线102和/或横轴线104旋转或枢转相邻的支柱120到展开状态而形成可变内部体积V。尽管在图1A中示出了6个支柱120，椎间设备可以包括任何数量的支柱，包括但不限于至少3个支柱、至少4个支柱、至少5个支柱、至少7个支柱、至少8个支柱、至少9个支柱、至少10个支柱、或至少在约2和20之间个支柱。为椎间设备选择的支柱120的数量可以根据针对椎间盘置换术的特定应用、骨移植或为了最佳匹配相邻椎骨的骨骼来选择。图1A示出了用于椎间设备100的6个支柱，所述6个支柱包括第一支柱120a、第二支柱120b、第三支柱120c、第四支柱120d、第五支柱120e和第六支柱120f，其中每一个相邻的支柱通常沿着纵轴线和/或横轴线可旋转地与相邻的支柱关联。一般来说，第二支柱120b和第三支柱120c放置在椎间设备100的远端112上，而第五支柱120e和第六支柱120f放置在近端110上。每一个相邻的支柱彼此可旋转地关联。
另选地，前表面108和/或后表面118包括粗糙的或齿状的表面130从而抓住椎骨板，如图1B所示。贯穿支柱120的前表面108和后表面118，齿状表面可以被隔开，其相对于前部108和后部118可以被设置为具有可变的厚度、高度和宽度，以及定向角度。在脊骨垫片100植入到患者的椎骨之后，齿状表面130可以被进一步设置为提供额外支承。齿状表面130可以减少椎间设备100在椎骨中的移动并且在椎骨和椎间设备100之间形成额外的摩擦。如果在患者的椎骨中植入多于一个的椎间设备100，一个椎间设备100的齿状表面130可以被设置为与其它椎间装置的齿相互作用和/或匹配，由此形成堆叠的椎间设备。当需要在椎骨中植入多个椎间设备时，这样的相互作用是有用的。齿状表面130可以被设置为具有远离脊骨垫片100的上部和下部的表面延伸的三角形凸出物的形状。三角形凸出物可以被设置为直角等腰三角形。三角形凸出物可以是任何尺寸和形状的三角形，其不必限于直角等腰三角形。此外，三角形凸出物可以被设置为远离椎间设备100的前表面或后表面（不论上表面或下表面）凸出一段距离，优选地是约0.03毫米。三角形凸出物还可以是以距离D间隔开，优选地是约0.1mm。本领域技术人员可以理解，齿状表面130可以被设置为具有任何形状、尺寸、或方向，以及可以远离脊骨垫片的表面凸出任何距离，并且在它们之间可以以任何距离分隔开。
如图1C所示，当椎间设备100处于闭合状态时，以及当多个相邻的支柱120向着支柱120的内表面旋转时，椎间设备100可以包括基本为零的可变内部体积V。当支柱120彼此关上或支柱的内表面128面向且邻接相邻的支柱的内表面时，椎间设备100包括零体积状态或闭合状态。这样，当椎间设备100处于闭合状态时，包括厚度为TT的剖面。选择厚度为TT的剖面来靠近在相邻的可能被损伤或未正确铰接的椎骨间的椎间隙。优选地，椎间设备100的远端112和近端110是锥形的，使得椎间设备100最小侵入，易于插穿切口位置或撤回组织，或通过楔入在损伤的相邻椎骨间容易地移位损伤的椎间隙。锥形的远端112和近端110可以相对于纵轴线102成一个角度。
如图2A所示，每一个支柱120包括从第一端124和第二端126延伸的纵向体构件122，其通常沿着纵轴线或支柱120的长度延伸。通过第一支柱的第一端124与第二支柱的第二端126可旋转地关联，并且第一支柱的第二端126与第三支柱的第一端124可旋转地关联，因此每一个支柱120与相邻的支柱120可旋转地关联。支柱120包括内表面128和外表面129，如图2B所示，其中，一般来说，内表面128面向内部体积V。在一个实施方式中，为了与相邻的支柱120可旋转地关联，第二端126包括枢轴销146并且第一端包括圆形壳体140，使得当每一个支柱120可旋转地连接到相邻的支柱时，枢轴销146位于圆形壳体140内，如图2A所示。圆形壳体140包括圆形腔142，其接近枢轴销146的尺寸或周长。枢轴销146基本上是具有圆柱轴的圆形销。枢轴销146或圆形腔142可以包括润滑剂从而允许相邻的支柱120枢转或旋转。一旦相邻的支柱旋转形成选择的内部体积V，枢轴销146可以通过在枢轴销146内的螺钉、螺栓或扣件被锁入位置。
如图2A所示，每一个支柱120包括宽度W，该宽度W从支柱120的前表面延伸到后表面。优选地，宽度W可以基于需要抵抗存在或缩短椎间隙的特定椎骨来选择。另选地，针对在相邻椎骨间必须被移植的骨的量来选择宽度W。例如，每一个椎间隙包括各种宽度，并且可以选择宽度W从而与特定的椎间隙匹配。每一个支柱120还包括长度L，该长度L从第一端124延伸到第二端126。在一个实施方式中，可以基于将被替换的椎间盘的尺寸选择长度L。每一个支柱120还包括厚度T。如果在相同的设备中厚度T不同，椎间设备100可以包括多个支柱。可以选择厚度T来适应在相邻椎骨间的空隙。例如，当椎间设备100基本处于闭合状态或零内部体积状态时，相邻的支柱120的厚度T将接近在相邻椎骨间的空隙。通过获取前表面108或后表面118的表面面积并且用支柱120的宽度W乘以表面面积，可以计算内部体积V。取决于在椎间设备100中包括多少支柱，通过获取每一个支柱的长度L并且计算椎间设备的表面面积，可以计算前表面108或后表面118的表面面积。例如，如果椎间装置包括6个支柱，其中每一个支柱包括相同的长度L，通过六角形结构用((3*sqrt(3))/2)*L^2计算面积，其中L是长度。在一个实施方式中，在展开状态下，表面面积可以在约200mm2和700mm2之间，另选地，在约250mm2和600mm2之间，另选地，在约260mm2和500mm2之间。
在一个实施方式中，纵向体构件122通常包括矩形或正方形的形状。另选地，纵向体构件122可以采用另选的形状并且可以包括梯形、六边形、多边形等。另选地，纵向体构件122的前表面和后表面可以是锥形的或成一个角度，使得支柱120的宽度W沿着支柱的长度L变化。如果相邻的椎骨变形或相对于椎间设备100的纵轴线102成一个角度，支柱120的宽度W的这种变化可以是优选的。
图2C-2D示出了与相邻的支柱的另选可旋转关联。在一个实施方式中，通过包括在第二端126上的穿通孔150和在第一端124上的捕获孔152，支柱120可以与相邻的支柱可旋转地关联。压配相邻的支柱120从而与穿通孔150和捕获孔152同轴地对齐，而销或螺钉穿过穿通孔150和捕获孔152。捕获孔可以包括螺纹部分从而固定其中的销或螺钉，从而当第一端124与第二端126可旋转地连接时，允许具有穿通孔150的支柱120围绕轴旋转。另选地，一旦相邻的支柱旋转到设定的角度，穿过穿通孔和捕获孔152的销或螺钉可以锁定相邻的支柱。
在一个另选实施方式中，如图2D所示，通过包括在第二端126上的凸出物160以及在第一端124上的配合孔124，支柱120可以与相邻的支柱可旋转地关联。配合孔162弯曲打开从而接收相邻的支柱120的凸出物160。另选地，凸出物160可以是开槽的圆形构件，其具有由槽提供的径向弹性和比其基座端部大的远端。配合孔162可以包括对应的内部卡槽使得一旦插入，凸出物160被径向按压直到扩大的远端经过并且被内部卡槽容纳，由此在配合孔162内永久地捕获凸出物160。一旦配合孔162接收凸出物160，相邻的支柱分别围绕第一端124和第二端126可旋转地关联。一旦相邻的支柱彼此以一个角度旋转，可以使用任何类型的扣件、螺栓或螺钉来锁定凸出物160和配合孔162。
如图3所示，相邻的支柱120旋转或枢转从而在相邻的支柱120之间形成角度A。可以根据在椎间设备100中的支柱120的数量选择角度A。另选地，可以针对骨包含根据要达到的内部体积V选择角度A。例如，当内部体积V更大时，角度A可以更大。另选地，可以根据椎间设备中包括的支柱的数量选择相邻的支柱间的角度A。在一个实施方式中，相邻的支柱120之间的角度A在30度和270度之间，另选地，在60度和240度之间，另选地，在90度和200度之间，另选地，在120度和170度之间。如上所述，一旦相邻的支柱以选择的角度A旋转，可以锁定或固定角度A。角度A的这种锁定或固定将内部体积V保持在静止或固定状态。
如图4A-B所示，当椎间设备100处于闭合状态当内部体积V基本为零时，椎间设备100可以包括在近端110和远端110的锥形部分。在这个实施方式中，远端112包括第二支柱120b和第三支柱120c，而近端110包括第五支柱120e和第六支柱120f。当第二支柱120b和第三支柱120c的内表面彼此邻接并且在远端112上靠近时，第二支柱120b和第三支柱120c可旋转地关联到闭合状态。当第五支柱120e和第六支柱120f的内表面彼此邻接并且在近端110上靠近时，第五支柱120e和第六支柱120f可旋转地关联到闭合状态。第一支柱120a和第四支柱120d与近端110和远端112可旋转地关联，使得当椎间设备100处于闭合状态时，第一支柱120a和第四支柱120d的内表面基本上彼此邻接。在一个实施方式中，第一支柱120a和第四支柱120d的外表面129可以包括涂层或光滑的边缘，从而协助椎间设备100经由切口点插入和/或在相邻的支柱之间滑动。
如图4B所示，当椎间设备100处于零内部体积V状态或闭合状态时，第五支柱120e和第六支柱120f以角度TA成锥形。相对于第一支柱120a和第四支柱120d以基本平行于椎间设备100的纵向轴线102设置角度TA。在一个实施方式中，锥度角TA在约0度和45度之间，另选地在约0度和30度之间，另选地，在约0度和15度之间，另选地，在约0度和5度之间。可以选择锥度角从而使椎间设备100经由切口或组织撤出点的插入最优化，在外科手术期间最小侵入，或接近将被楔入的损伤的椎间隙。
在椎间设备100的一个另选实施方式中，如图4C所示，椎间设备100包括锁定机构180从而当其处于展开状态时，锁定椎间设备100。锁定机构180可以是通常沿着横跨第一支柱120a至第四支柱120d的横轴104设置的销。另选地，锁定机构140可以是螺纹销，由此至少一个支柱120包括互补螺纹（complimentary thread）来接收锁定机构。另选地，锁定机构180通常沿着纵轴线可以从任何相对的支柱横跨。锁定机构180可以协助将椎间设备100保持在展开状态下并且保持特定的内部体积V。另选地，在第一端124或第二端126的可旋转部分内，每一个支柱的第一端124和第二端126可以包括铰接锁定机构。铰接锁定机构可以被固定在另选的或另外的锁定机构140中从而进一步将可旋转关联锁到或固定在支柱120的第一端124和第二端126上。
图5示出了椎间设备300的另选实施方式。椎间设备300包括8个可旋转关联的支柱120和一个内部体积V。椎间设备300包括第一支柱120a、第二支柱120b、第三支柱120c、第四支柱120d、第五支柱120e、第六支柱120f、第七支柱120g和第八支柱120h，其中每一个相邻的支柱与相邻的支柱可旋转地关联。
在操作中，外科手术的第一顺序是通过进入椎间隙510，移除环的一部分，撤出核，然后移除软骨终板，来准备椎间隙。如图6A-C所示，椎骨500包括通常沿着z轴线示出的颅尾轴线，通常沿着x轴线示出的左右轴线，以及通常沿着y轴线示出的背腹轴线。一旦准备好椎间隙510，椎间设备被连接到用于植入的仪器系统并且将椎间设备100展开在椎间隙510中。然后，椎间设备绕着其横轴线旋转并且以椎间设备的宽度TT平行于椎骨终板或第一支柱120a和第四支柱120d的外表面129将椎间设备放置在椎间隙510中，如图6A所示。接下来，如图6B所示，椎间设备绕着其横轴线旋转90度从而增加椎间隙的高度，然后椎间设备展开至展开状态，由此内部体积V被多个支柱围绕，使得椎间设备“打开”。接下来，椎间设备增加内部体积V并且将促进骨融合的化合物放入内部体积V中，包括但不限于自体骨、同种异体骨、骨形态发生蛋白（BMP)，和/或任何数量的用于骨移植密闭的合适的生物材料，如图6C所示。
图7示出了针对使用椎间设备100的方法200的示意图。步骤210通过移除环的一部分，撤出核，并且然后移除软骨终板，来准备椎间隙。步骤212椎间设备围绕其横轴线旋转并且将椎间盘放入椎间隙中使椎间设备的宽度TT平行于椎骨终板。步骤214椎间设备围绕其横轴线旋转90度从而增加椎间隙的高度。步骤216展开椎间设备从而增加由多个支柱围绕的内部体积V，使得椎间装置“打开”。可选步骤218用多个支柱之间的锁定机构锁定椎间设备。最终步骤220用骨移植材料填充内部体积V从而允许相邻椎骨间的骨融合。
本领域技术人员可以理解，椎间设备100和/或任何其部件可以具有任何尺寸、形状、长度、厚度、高度、重量或任何其它参数。这些参数可以由外科医生（或其他有资格的专业人员）选择来执行特定的步骤。此外，椎间设备100和/或任何其部件可以由金属、塑料、合成材料、或其它合适的材料，或其任何组合制造。在一个实施方式中，椎间设备100由钛、镍钛诺、或不锈钢、热解碳、任何生物兼容性材料、或任何医用级聚合物，例如聚醚醚酮（PEEK）构成。
在一些实施方式中，支柱120被包括在各种长度和配置中，并且可以还包括各种特征从而适应针对椎间衬垫的不同应用。支柱120可以由各种材料构造，从而协助无线电半透明、强度、弹性，和集成解剖等。
结合各种实施方式描述了本发明，应理解本发明还可以进一步修改。本申请旨在覆盖本发明的任何变型、使用或改写，这些变型、使用或改写总地来说遵循本发明的原则，并且包括未公开在本发明中但在本发明所属技术领域内属于公知和习惯性做法的内容。

Claims (20)

1.一种椎间设备，该设备包括：
多个支柱，其中每一个相邻的支柱与每一个相邻的支柱可旋转地关联，从而当所述椎间设备处于展开状态时为骨移植包含形成可变内部体积V，由此所述内部体积V被所述多个支柱围绕。
2.根据权利要求1所述的椎间设备，其中所述椎间设备还包括近端部和远端部，以及纵轴线和横轴线；并且所述多个支柱一般沿着至少所述纵轴线或所述横轴线旋转，从而展开或接触所述可变内部体积V。
3.根据权利要求1所述的椎间设备，其中所述椎间设备还包括前表面和后表面，其中所述前表面或所述后表面中的至少一个包括齿状表面。
4.根据权利要求1所述的椎间设备，其中当所述多个相邻的支柱向着其它支柱旋转时，所述内部体积V基本为零。
5.根据权利要求5所述的椎间设备，其中为了输送所述椎间设备，当所述内部体积V基本为零时，远端部和近端部是锥形的。
6.根据权利要求1所述的椎间设备，其中每一个支柱包括从所述支柱的第一端和第二端延伸的纵向体构件。
7.根据权利要求6所述的椎间设备，其中第一端包括圆形壳体并且第二端包括枢轴销，使得当每一个支柱可操作地连接到相邻的支柱时，所述枢轴销位于所述圆形壳体内并且允许围绕相邻的支柱的第一端和第二端旋转。
8.根据权利要求6所述的椎间设备，其中每一个支柱包括从所述支柱的前表面延伸到后表面的宽度W，并且所述宽度W在需要抵抗存在或缩短椎间隙的特定椎骨上选择。
9.根据权利要求6所述的椎间设备，其中第一端包括捕获孔并且第二端包括穿通孔，其中相邻的支柱被压配从而与所述穿通孔和捕获孔同轴地对齐，并且销经由所述穿通孔和所述捕获孔穿过从而允许围绕相邻的支柱的第一端和第二端可旋转地关联。
10.根据权利要求6所述的椎间设备，其中第一端包括配合孔并且第二端包括凸出物，其中所述配合孔弯曲打开从而接收相邻的支柱的所述凸出物以围绕第一端和第二端与相邻的支柱可旋转地关联。
11.根据权利要求1所述的椎间设备，该设备还包括被设置为在所述展开状态下锁定椎间盘的锁定机构。
12.一种椎间设备，该设备包括：
具有围绕内部体积V的内表面的多个可旋转连接的支柱，每一个支柱包括从第一端和第二端延伸的纵向体构件；
沿着体的横轴线相对地设置的近端和远端；并且
其中当所述多个相邻的支柱向着所述支柱的内表面旋转时，所述内部体积V处于闭合状态，并且当所述多个相邻的支柱远离所述支柱的内表面旋转时，所述内部体积V处于展开状态。
13.根据权利要求12所述的椎间设备，其中第一端包括圆形壳体并且第二端包括枢轴销，使得当每一个支柱可操作地连接到相邻的支柱时，所述枢轴销位于所述圆形壳体内并且允许围绕相邻的支柱的第一端和第二端旋转。
14.根据权利要求12所述的椎间设备，其中第一端包括捕获孔并且第二端包括穿通孔，其中相邻的支柱被压配从而与所述穿通孔和捕获孔同轴地对齐，并且销经由所述穿通孔和所述捕获孔穿过，从而允许围绕相邻的支柱的第一端和第二端可旋转地关联。
15.根据权利要求12所述的椎间设备，其中第一端包括配合孔并且第二端包括凸出物，其中所述配合孔弯曲打开从而接收相邻的支柱的所述凸出物从而围绕第一端和第二端与相邻的支柱可旋转地关联。
16.根据权利要求12所述的椎间设备，该设备还包括被设置为在所述展开状态下锁定椎间盘的锁定机构。
17.根据权利要求12所述的椎间设备，其中为了输送所述椎间设备，当所述内部体积V基本为零时，远端部和近端部是锥形的。
18.根据权利要求12所述的椎间设备，其中每一个支柱包括从所述支柱的前表面延伸到后表面的宽度W，并且所述宽度W可以不变或可以根据需要抵抗存在或缩短椎间隙的特定椎骨而改变。
19.一种使用椎间设备的方法，该方法包括以下步骤：
通过移除环的一部分，撤出核，并且然后移除软骨终板来准备椎间隙；
围绕所述椎间设备的横轴线旋转所述椎间设备，并且将椎间盘以椎间设备的宽度TT平行于椎骨终板的方式放置在椎间隙中；所述椎间装置包括：多个支柱，其中每一个相邻的支柱与每一个相邻的支柱可旋转地关联，从而当所述椎间设备处于展开状态时为骨移植包含形成可变内部体积V，由此所述内部体积V被所述多个支柱围绕；
围绕椎间设备的横轴线旋转所述椎间设备90度从而增加所述椎间隙的高度；
展开所述椎间设备从而增加由所述多个支柱围绕的所述内部体积V，使得所述椎间设备打开；以及
用骨移植材料填充所述内部体积V，从而允许在相邻的椎骨间的骨融合。
20.根据权利要求19所述的方法，该方法还包括当所述椎间设备被展开从而增加所述内部体积V时，在所述多个支柱之间用锁定机构锁定所述椎间设备。
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