CN101257864A - 脊椎盘腔牵引用的设备和方法 - Google Patents

脊椎盘腔牵引用的设备和方法 Download PDF

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CN101257864A
CN101257864A CNA2005800378476A CN200580037847A CN101257864A CN 101257864 A CN101257864 A CN 101257864A CN A2005800378476 A CNA2005800378476 A CN A2005800378476A CN 200580037847 A CN200580037847 A CN 200580037847A CN 101257864 A CN101257864 A CN 101257864A
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filling member
spinal disc
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菲利普·S.·元
林宽库
罗伯特·M.·斯克里布纳
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Crosstrees Medical Inc
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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
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • 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
    • A61F2/441—Joints for the spine, e.g. vertebrae, spinal discs made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
    • 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
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30677—Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
    • 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
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A61F2002/444—Intervertebral or spinal discs, e.g. resilient for replacing the nucleus pulposus

Abstract

一个用来将药用填充物插入脊椎盘内的可抽出的设备。该设备包括一个填充件和一个流质药。填充件用挠性可渗透壁制成，上有一个存药区和一个喷射口，在填充件插入到脊椎盘内后，流质药就是通过该喷射口喷射到存药区内。存药区有一个开口，该开口可以用一根或多根细线的一端扎紧，但也可以松开，从而形成该开口防漏。流质药在填充件的存药区内凝固后，细线的另一端可以抽出，使存药区的开口松开，从而，可以将填充件从脊椎盘中抽出，只将药留存在脊椎盘中。

Description

脊椎盘腔牵引用的设备和方法
技术领域
本发明一般涉及一种在脊椎病修复手术治疗中使用的仪器。特别是，这种手术仪器可以用来将医用材料插入脊椎盘，而后，该仪器又可以与医用材料脱开，并从脊椎盘中抽出，而医用材料则留存在脊椎盘中起修复作用。
背景技术
一般来讲，脊椎盘疾病的手术治疗可以通过几种方法进行，其中包括药物皮下注射，药物球囊插入和药物填充物插入等方法，例如，美国专利(专利号：5,976,186，6,508,839和6,602,291)都分别公开了治疗脊椎盘疾病的方法，诸如置放一个修复设备或对损坏的脊椎盘结构进行重构。在脊椎盘破裂要求植入治疗物质时，这些方法都有缺陷。为此，最理想的办法是，有调节的输入一种流质物质作为治疗植入物放入脊椎盘中，而且要求这种流质物质对脊椎盘的损伤最小。如果不是采用有调节的输入，那么这种药物就不会得到保留，就有可能对周围组织造成伤害。
为了防止上述方法所带来的缺陷，人们采用插入填充物的方法来将医用材料植入脊椎盘内，这样该医疗物质就被留存在脊椎盘内，从而就只将该医疗物质植入在脊椎盘内。
发明内容
一种用来将医用填充物插入脊椎盘内的可抽出的设备，所述设备包括：
一个填充件，包括一个挠性壁并带有一个存药区，存药区的一端有一个喷射口，而存药区的另一端有一个开口；
一根或多根细线，每个细线的一端用来扎紧所述存药区的开口，且又易于松开；所述开口是防漏的；
一种流质药，在将所述填充件插入脊椎盘之后，将一种流质药通过所述填充件的喷射口喷入所述存药区，从而使得所述流质药可以在所述填充件的存药区内凝固；
当所述细线的另一个端被外力拉动时，所述存药区的开口就会被解开，这样，所述填充件就可以从脊椎盘中抽出，以便只将所述流质药留放在脊椎盘内。
其特征在于：所述填充件的存药区填满后实际上就成管状，其特征在于：垂直于存药区纵轴线的横断面实际上从存药区的喷射口到开口方向呈椭圆形。
所述挠性壁最好带有若干个通孔，而且该壁是可渗透的。所述挠性的可渗透壁可以是单层的或多层的结构。
所述流质药最好是一种聚合物质，例如在调和成非粘性状态前为流质的，诸如PMMA(聚甲基丙烯酸甲酯)、硅、聚氨酯、聚酯、或其它聚合物。
本发明的设备最好还包括一个喷射工具，可经由所述喷射口将流质药喷入存药区。
所述喷射工具最好包括一个导管和一个注射器，其特征在于：所述导管的一端连接到所述填充件的喷射口，而所述导管的另一端接到装有流质药的注射器内，这样流质药就能够通过注射器经由喷射口和导管喷到所述填充件的存药区内。
本发明的设备最好还包括一个工作管，用来插入脊椎盘内，这样填充件和导管就可以一起插入该工作管内，所述填充件就可以放置在脊椎盘内。
所述管状壁最好带有若干个通孔，并且是可渗透的。
本发明还披露了将凝固药植入脊椎盘的方法，包括：
将填充件插入脊椎盘的孔内，所述填充件包括一个挠性的可渗透的壁，带有一个存药区，该存药区的一端是一个喷射口，另一端是一个开口，其特征在于：提供有一个或多个细线，每根细线的一端用来扎紧所述存药区的开口，且又可以松开，这样所述开口可以防漏；其特征在于：所述填充件的存药区在填充满后实际上呈管状，其中垂直于存药区纵轴线的横断面实际上从存药区的喷射口到开口方向呈椭圆形。
将流质药经由所述填充件的喷射口喷入存药区，这样，所述存药区就会膨胀，流质药在填充件的存药区内凝固；
通过拉动所述细线的另一端来松开存药区的开口，从而可以将所述填充件从脊椎盘中抽出，只将所述凝固药留存在脊椎盘中。
其特征在于：所述凝固药的形状与膨胀后的存药区形状相似。
本发明的方法最好还包括将一个喷射工具固定到所述填充件上，但又可以分开，这样所述流质药就可以经由喷射工具喷入存药区内。所述喷射工具最好包括一个导管和一个注射器，其中，所述导管的一端连接到所述填充件的喷射口，而所述导管的另一端则连接到存有流质药的注射器上，其特征在于：所述流质药是通过注射器经由喷射口和导管喷射到所述填充件的存药区内。
本发明的方法最好还包括将一个工作管插入所述脊椎盘内，以及将所述填充件和导管一起插入所述工作管内，所述填充件可以放置在脊椎盘内。
本发明的填充件的挠性壁采用生物相容的或生物合成的材料制成，例如聚合物、橡胶、弹性塑料、PTFE(聚甲基丙烯酸甲酯)、聚酯纤维等类似材料。挠性壁上带有若干孔，因此挠性壁是可以渗透的。如果挠性壁是用所选择的材料编织而成时，则就已经提供了这种通孔，如果是使用了一层选择材料的薄膜时，则需要通过钻孔来提供这些通孔。挠性壁可以采用囊、袋、球、筒或矩形柱集成在一起或通过将各个部分连接在一起的形式形成一个物体。
本发明的填充件可以包含一种不透射线的材料，例如金属丝，成像系统(例如X射线成像设备)可以通过金属丝很容易地查找到填充件的确切位置。
本发明的填充件的挠性壁可以是单层的或多层的结构，取决于药的粒径和粘性。如果药的粒径较大，挠性壁最好为两层结构。如果药的粘性较高，挠性壁最好也为两层结构。然而，如果药的粒径较小而且药的粘性较低时，挠性壁最好为三层或四层结构。
下面结合附图并慎重考虑了本发明的最佳实施例之后，可以更清楚的了解本发明的特性和优点。
附图说明
图1为本发明的可抽出的填充物的示意图。
图2为本发明填充件存药区开口扎紧时的示意图。
图3a为本发明填充件单层结构壁的纵向剖面图。
图3b为本发明填充件多层结构壁的纵向剖面图。
图4a为置放在脊椎盘内的填充件的剖面图。
图4b为放置在脊椎盘内的装满了流质物质的填充件的剖面图。
图5a为填充件的剖面图，所述开口处于打开状态。
图5b为填充件从脊椎盘内抽出时的剖面图。
图6a为剖面图，示出了脊椎盘内的流质物质。
图6b为剖面图，示出了脊椎盘内的流质物质不止一个。
具体实施方式
如图1所示，本发明所实施的一种可抽出的填充物10包括一个填充件20，一个流质药30，一个导管40和两根细线50和51。填充件20形成了一个挠性壁21，且提供有一个存药区22和一个喷射口23。挠性壁21可以采用橡胶或一个带有若干孔的挠性塑料材料或一种织物制成。流质药30通过导管40和喷射口23喷射到存药区22内。虚线3-3示出了填充件20部分的运行方向。
如图2所示，填充件20的存药区22提供有一个开口24，正好与填充件20的喷射口23相对。开口24用两根细线50和51捆扎。第一根细线50有一个第一端501和一个第二端502，而第二根细线51也有一个第一端511和一个第二端512。两根细线50和51实际上都绑扎在开口24附近的挠性壁21上，两根细线可以松开。图中没有示出这两根细线系紧在一起的方式。
填充件20存药区22的开口24牢固地束紧，防止流质药30经由两根细线50和51从存药区22流出，因为两根细线以这样的一种方式缠绕在一起，即第二根细线51的第一端511缠绕在第一根细线50的周围，但是可以松开的。在缠绕过程结束后，开口24周围的挠性壁21就位于两根细线50和51之间的位置。此后，第一根细线50的两端501和502和第二根细线51的第一端511分别同时向右和向左拉动，如图2所示。结果，填充件20的开口24就成为防渗漏的。在第二根细线51的第二端512向喷射口23方向拉动时，填充件20的开口24就会解开。结果，两根细线50和51就会松开。而后，第一根细线50的第一端501和第二根细线51的第二端512就分别向背离填充件20开口24的方向拉动，如图5a所示。这样，开口24就完全被松开了。
填充件20的挠性壁21是单层结构，如图3a所示，或为多层结构，如图3b所示。挠性壁21提供有若干孔211，供液体渗入。如果挠性壁21为多层机构，挠性壁21则采用这样的方式叠加，即这些孔在位置上都不是对应的，目的是减缓液体的流通。
如图4a所示，可抽出填充物10的填充件20插入脊椎盘70上的孔71内，其特征在于：工作管51提前插入孔71内，以便安装导管40、细线50和51以及填充件20。然后，通过与导管40相连的注射器将流质药喷射到填充件20的存药区21内。导管40的一端41位于存药区21内，而另一端42与注射器80的管子612的一端611相连。柱塞62插入管子612的另一端，后者内部装有糊状药30。这样，填充件20就因为糊状药30而膨胀，如图4a和图4b所示。
所述流质药30最好为聚合物质，如混合物体，在调和成非粘性状态前为可流动的，例如PMMA(聚甲基丙烯酸甲酯)、硅、聚氨酯、聚酯或其它聚合物。
填充件20内的糊状药30在脊椎盘70内完全凝固后，必须将填充件20从脊椎盘70的孔71内抽出，只将糊状药30留在脊椎盘70内。填充件20从脊椎盘70的孔内抽出时，第二根细线51的第二端512首先顺填充物开口23方向拉动。结果，两根细线50和51就会松开。此后，第一根细线50的第一端501和第二根细线51的第二端512就分别与填充件20开口24的相反方向拉动，如图5a所示。结果，开口24就完全松开了。
在开口24被松开后，通过拉动在所述填充件20存药区喷射口23处与导管40相连的挠性壁21的一端，就可以将挠性壁21从凝固药30处退出，这样，所述凝固药30就与所述填充件20脱离，从而就置放在脊椎盘70内，如图5b所示。填充件和导管40就从脊椎盘70的孔中拉开，只将所述凝固药留放在脊椎盘70内。
本发明可抽出填充物10的填充件20挠性壁21可以呈曲线轮廓。如图6a所示，喷射到脊椎盘70内填充件20中的流质药30在留存到脊椎盘70内时也将呈曲线轮廓。
如图6b所示，填充件20在脊椎盘内放置位置可以不止一个，流质药30在脊椎盘70内的留存位置也就不止一个。
上面的实施例在各个方面来讲都只是说明性的，而不是限制性的。采用其它具体形式实施本发明时都没有超出本发明的下述权力要求范围。

Claims (13)

1. 将医用填充物插入脊椎盘的一种可抽出的设备，所述设备包括：
一个填充件，包括一个挠性壁和一个存药区，存药区一端是一个喷射口，存药区的另一端是一个开口；
所述存药区的所述开口可以是一个或多个细线扎紧的，但又可以松开的，所述开口是防漏的；
在将所述填充件插入脊椎盘过程之后，将一种流质药通过所述填充件的所述喷射口喷入所述存药区；
所述存药区的所述开口可以打开，从而可将所述填充件从脊椎盘抽出，只将所述流质药留放在脊椎盘内。
2. 根据权力要求1所述的设备，其特征在于：所述挠性壁上有若干个通孔，且挠性壁是可渗透的。
3. 根据权力要求2所述的设备，其特征在于：所述挠性渗透壁可以是单层的，也可以是多层的结构。
4. 根据权力要求1所述的设备，其特征在于：流质药是一种可以调成非粘性状态的聚合物。
5. 权力要求1所述的设备，又包括一个喷射工具，用来将所述流质药经由所述喷射口喷射到所述存药区。
6. 根据权力要求5所述的设备，其特征在于：所述喷射工具包括一个导管和一个注射器，其特征在于：所述导管的一端连接到所述填充件的所述喷射口，所述导管的另一端接到装有所述流质药的所述注射器上，这样，所述流质药就可以通过所述注射器经由所述喷射口和所述导管喷射到所述填充件的所述存药区内。
7. 权力要求6所述的设备，又包括一个工作管，用来插入到所述脊椎盘中，这样，所述填充件和所述导管就可以一起插入到所述工作管中，所述填充件可以置放在所述脊椎盘内。
8. 根据权力要求3所述的设备，其特征在于：所述管状壁上有若干通孔，是可以渗透的。
9. 一种将凝固药植入脊椎盘的方法，包括：
将填充件插入脊椎盘的孔中，所述填充件包括一个挠性可渗透壁，带有一个存药区，存药区的一端有一个喷射口，存药区的另一端有一个开口，其特征在于：提供有一个或多个细线，每根细线的一端扎紧所述存药区的所述开口，但又可以松开，这样所述开口可以防漏；其特征还在于：所述填充件的所述存药区是可膨胀的；
将流质药经由所述填充件的所述喷射口喷入所述存药区，这样，所述存药区就会膨胀，所述流质药在所述填充件的所述存药区内凝固；
通过拉动所述细线的另一端来松开所述存药区的所述开口，从而可以将所述填充件从脊椎盘中抽出，只将所述凝固药留存在脊椎盘中。
其特征在于：所述凝固药的形状与膨胀后的存药区的形状相似。
10. 根据权力要求9所述的方法，其特征在于：所述流质物质是一种可以调成非粘性状态的聚合物质。
11. 权力要求9所述的方法，又包括将喷射工具与所述填充件系紧在一起，但又可以分开，这样所述流质药就可以经由所述喷射工具喷入所述存药区。
12. 根据权力要求11所述的方法，其特征在于：所述喷射工具包括一个导管和一个注射器，其中，所述导管的一端连接到所述填充件的所述喷射口，而所述导管的另一端则连接到装有所述流质药的所述注射器上，其特征在于：所述流质药是通过所述注射器经由所述喷射口和所述导管喷射到所述填充件的所述存药区内。
13. 权力要求12所述的方法，又包括将工作管插入所述脊椎盘的所述孔中，和将所述填充件和所述导管一起插入工作管中，这样所述填充件就置放在所述脊椎盘内。
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