CN113811267A - 在椎体间引导椎体间间隔件的系统 - Google Patents

在椎体间引导椎体间间隔件的系统 Download PDF

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CN113811267A
CN113811267A CN202080034853.0A CN202080034853A CN113811267A CN 113811267 A CN113811267 A CN 113811267A CN 202080034853 A CN202080034853 A CN 202080034853A CN 113811267 A CN113811267 A CN 113811267A
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筱崎义雄
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Riga Ais Co ltd
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Abstract

提供一种即使在狭窄的手术区域中也能够容易且准确地将椎体间间隔件设置于椎体间的规定的位置的简单的系统。该系统是用于治疗脊椎疾病的系统，具有：插入椎体与椎体之间使用的沿水平方向弯曲的椎体间间隔件，该椎体间间隔件具备：凸状的腹侧面，其具备与各椎体抵接的一对抵接面，在腹侧连接抵接面；及凹状的背侧面，其在背侧连接抵接面，在腹侧面和/或背侧面具有沿着弯曲的方向的卡合部，以及引导器具，其将椎体间间隔件引导至椎体与椎体之间的规定位置，在远端侧具有与腹侧面或背侧面中的任一个卡合部嵌合的导轨部，导轨部在俯视时的曲率半径与腹侧面或背侧面在俯视时的曲率半径实质相同。

Description

在椎体间引导椎体间间隔件的系统
技术领域
本发明涉及在椎体间引导椎体间间隔件的系统。
背景技术
例如，为了得到基于PLIF(后方路径腰椎椎体间固定手术)的骨愈合，椎体间间隔件的使用不可或缺，通过尽可能大地插入适于椎体间的形状的间隔件，能够使椎体间更稳定化，获得更牢固的固定。另外，大的间隔件期待能够填充更多的移植骨等，认为有助于将来的椎体间骨愈合。
在通过单侧接近、单侧椎间关节切除进行的以往的使用箱型椎体间间隔件的仅单侧的椎体间间隔件插入中，担心会残留对侧的椎间不稳定性，有可能不利于骨愈合。另外，在通过两侧接近、两侧椎间关节切除进行的两侧的箱型椎体间间隔件插入中，反而有可能引起椎间不稳定性。相对于此，通过单侧接近、单侧椎间关节切除进行的向对侧插入椎体间间隔件、或以往的飞镖型椎体间间隔件的插入，由于能够在保持对侧的椎间关节的同时支撑通过对侧支撑，因此是合理的方法。
现有技术文献
专利文献
专利文献1：日本特表2012-532693号公报
专利文献2：日本特表2016-512107号公报
专利文献3：日本特表2019-517891号公报
发明内容
发明所要解决的课题
在椎体间插入设置椎体间间隔件时，将图1所示的椎体1之间的椎间板2的纤维环打开而去除内部的髓核，在该去除后的椎体间插入椎体间间隔件而进行设置。由于脊髓神经系统、血管通过椎间板2的附近，因此在手术中要求细心的注意。
脊柱承担支撑体重的作用，因此要求椎体间间隔件覆盖高的刚性和椎体间的较大的面积，并且手术的手术区域狭窄，在附近通过神经系统、血管，因此需要在避开它们的同时在适当的位置设置椎体间间隔件的技工量、手术系统。
如上所述，现有的飞镖型椎体间间隔件的插入是由于能够在保持对侧的椎间关节的同时将其支撑到对侧的方法。但是，在将椎体间间隔件送入到对侧时，需要与术中透视装置并用或高度的技术。
另外，在以往的椎体间间隔件中，能够从狭窄的插入口插入的椎体间间隔件的大小受到限定。因此，目前开发了在具有挠性的椎体间间隔件、椎体间内部改变朝向的插入器具等，但很多系统在结构上复杂或从伴随于此的脆弱性能够实用化的系统较少。
在专利文献1所记载的系统中，椎体间间隔件通过挠性的桥接件而相互连接。椎体间间隔件成为被放入插入管并通过插入管内而插入设置于椎体之间的机构。椎体间间隔件的构造复杂，椎体间间隔件的刚性变低。另外，在所公开的实施例中，插入器具具备引导椎体间间隔件的底面的导轨和引导底面、上表面及侧面的导轨，因此在狭窄的手术区域引导椎体间间隔件存在问题。
在专利文献2所记载的系统中，椎体间间隔件具有能够扩展的功能。成为在非扩张状态下在椎体之间使用器具设置椎体间间隔件之后，在椎体间内扩展椎体间间隔件的系统。椎体间间隔件通过销等连结有大量的部件，构造复杂且刚性降低。另外，在椎体间以非扩张状态设置椎体间间隔件之后，必须扩展椎体间间隔件，因此系统复杂且需要手术中的医生的高技巧。
在专利文献3所记载的系统中，椎体间间隔件是一体物具有刚性。设置椎体间间隔件的器具有把持椎体间间隔件所具备的销的把持部，医师必须在狭窄的手术区域中一边调整椎体间间隔件的朝向一边设置，因此具有难以进行手术的问题。
本发明的目的在于提供一种简单的系统，即使在狭窄的手术区域中，也能够容易地将椎体间间隔件准确地设置于椎体间的规定的位置。
解决课题的手段
本发明(1)的系统，是用于治疗脊椎疾病的系统，其特征在于，该系统包括：插入椎体与椎体之间使用的沿水平方向弯曲的椎体间间隔件，该椎体间间隔件具备：腹侧面，其具备与各所述椎体抵接的一对抵接面，在腹侧连接该一对抵接面，在俯视时为凸状的腹侧的侧面；及背侧面，其在背侧连接该一对抵接面，在俯视时为凹状的背侧的侧面，在所述腹侧面和/或背侧面具有沿着所述弯曲的方向的卡合部，以及引导器具，其将所述椎体间间隔件引导至所述椎体与所述椎体之间的规定位置，在远端侧具有与所述腹侧面或背侧面中的任一个卡合部嵌合的导轨部，该导轨部在俯视时的曲率半径与所述腹侧面或所述背侧面在俯视时的曲率半径实质相同，
所述卡合部及所述导轨部的横截面中的任一方是凹形状，另一方是与所述凹形状对应的凸形状，所述凹形状具有比与所述凸形状对置的该凹形状的开口宽度宽的最大宽度的部分。
在本发明(1)的系统中，在椎体间间隔件的腹侧面和/或背侧面具备沿着所述弯曲的方向的卡合部。在引导器具的远位端侧具有与所述腹侧面或背侧面中的任一个卡合部嵌合的导轨部。该导轨部的俯视时的曲率半径与所述腹侧面或背侧面的俯视时的曲率半径实质上相同，因此能够使椎体间间隔件沿着导轨部移动。只要将引导器具设置在规定的位置，就能够将椎体间间隔件准确且容易地引导至椎体间的规定的适当的位置。
若使用本系统，则例如在从TLIF(经椎间孔式腰椎椎体间固定手术)方法插入的情况下，硬膜以大致的中心回旋，从椎间的外侧缘以与前缘、对侧的外侧缘相接的方式插入。通过沿着预先设置在椎体之间的引导器具的导轨部插入椎体间间隔件，能够安全更准确且容易地将椎体间间隔件插入至对侧的最佳位置。
本发明(2)是本发明(1)的系统，其特征在于，所述导轨部的横向宽度为在所述椎体间间隔件的所述腹侧面和/或所述背侧面的高度以下。这样，通过使导轨部的横向宽度尺寸为椎体间间隔件的腹侧面和/或背侧面的高度以下，即使在狭窄的手术区域也能够顺畅地将椎体间间隔件设置于椎体间的规定的位置。
本发明(3)是本发明(1)或(2)的系统，其特征在于，所述卡合部的横截面为T字状的凹形状，所述导轨部的横截面为T字状的凸形状。
在本发明(3)中，椎体间间隔件侧的卡合部的横截面为T字状的凹形状，导轨部的横截面为T字状的凸形状，因此能够将椎体间间隔件沿着导轨部的凸形状的轨道引导而容易地设置于椎体间的规定的位置。
本发明(4)是本发明(1)或(2)的系统，其特征在于，所述卡合部的横截面为T字状的凸形状，所述导轨部的横截面为T字状的凹形状。
在本发明(4)中，与本发明(3)相反，椎体间间隔件侧的卡合部的横截面为T字状的凸形状，导轨部的横截面为T字状的凹形状，因此椎体间间隔件能够沿着导轨部的凹形状的轨道被引导而容易地设置于椎体间的规定的位置。
本发明(5)是一种椎体间间隔件，其特征在于，是本发明(1)～(4)中任一项所述的椎体间间隔件。通过使用这样的椎体间间隔件，能够在椎体间的规定的位置准确且容易地设置椎体间间隔件。
本发明(6)是一种引导器具，其特征在于，是本发明(1)～(4)中任一项所述的引导器具。通过使用这样的引导器具，能够在椎体间的规定的位置准确且容易地设置椎体间间隔件。
发明的效果
根据本发明的系统，系统简单，因此即使在狭窄的手术区域中，也能够容易地将椎体间间隔件准确地设置在椎体之间的规定的位置。
附图说明
图1是表示脊椎(腰椎)的侧面图。
图2是表示在椎体间设置了引导器具的立体图。
图3是表示本发明的椎体间间隔件的实施例1的立体图。
图4是表示本发明的椎体间间隔件的实施例1的俯视图、内侧面图、外侧面图及腹侧面图。
图5是表示本发明的引导器具的实施例2的立体图。
图6是表示本发明的引导器具的实施例2的俯视图。
图7是表示本发明的引导器具的实施例3的立体图。
图8是表示本发明的引导器具的实施例3的俯视图。
图9是示意性地表示使本发明的椎体间间隔件与实施例2的引导器具的导轨部内周和椎体间间隔件的腹侧面卡合，并将2个椎体间间隔件对称地设置在椎体之间的状态。
图10是示意性地表示使本发明的椎体间间隔件与实施例3的引导器具的导轨部内周和椎体间间隔件的背侧面卡合，并将2个椎体间间隔件对称地设置在椎体之间的状态。
图11是示意性地表示本发明系统的椎体间间隔件与引导器具的导轨部的卡合状态的具体例。
具体实施方式
以下，参照附图对本发明的实施方式进行说明。在以下的说明中，上下是指图的上下。该“上下”是方便起见的称呼，在设置时，有时上下相反或水平。
图2表示从腹侧观察在头侧椎体1A与尾侧椎体1B之间的椎体之间插入设置有引导器具30的导轨部31的状态的示意图。手术者抓住并插入把持部32。实际上，由于头侧椎体1A与尾侧椎体1B之间的椎体之间的周围被称为纤维环的组织包围，因此无法从腹侧观察，但为了了解设置状态，省略了纤维环进行表示。
图3表示从腹侧观察本发明的椎体间间隔件的实施例1时的立体图。上表面13与头侧椎体1A的尾侧面抵接，下表面14与尾侧椎体1B的头侧面抵接。外侧面11和内侧面12位于沿着中心轴CL的两端部。整体形状为腹侧弯曲成凸状的形状。腹侧的侧面为腹侧面17，凹状的侧面为背侧面18。在上表面13和下表面14刻入用于使头侧椎体1A和尾侧椎体1B分别牢固地结合的槽等，但在图3中，省略这些槽等来表示。
实施例1的椎体间间隔件10设有2个贯通上表面13和下表面14的孔，这2个孔被中间部15分隔。这些孔被称为骨移植部16，其中，用于填充患者的自体骨、人工骨等骨亲和性高的材料。在图3的腹侧面17形成有与后述的引导器具卡合的卡合部20。这些孔的数量并不限定于2个，在本发明中，这些孔不是必须的，也可以是没有孔的椎体间间隔件。
图4表示椎体间间隔件10的实施例1的俯视图、内侧面图、外侧面图及腹侧面图。图4的(A)是俯视图，图4的(B)是内侧面图，图4的(C)是外侧面图，图4的(D)是腹侧面图。图中的H1是腹侧面17的高度，H2是背侧面18的高度。
图5表示实施例2的引导器具30的立体图，图6表示实施例2的引导器具30的俯视图。在引导器具30形成有与椎体间间隔件10的卡合部20卡合的导轨部31和手术者把持的把持部32。在图6中，示出形成于椎体间间隔件10的腹侧面17的卡合部20与导轨部31卡合的状态。图5中的W是导轨部31的横向宽度。
图7表示实施例3的引导器具30的立体图，图8表示实施例3的引导器具30的俯视图。在引导器具30形成有与椎体间间隔件10的卡合部20卡合的导轨部31和手术者把持的把持部32。在图8中，示出形成于椎体间间隔件10的背侧面18的卡合部20与导轨部31卡合的状态。图7中的W是导轨部31的横向宽度。
图9示意性地示出使用实施例2的引导器具30而将2个椎体间间隔件10设置于椎体之间的步骤。在图9(A)中，避开神经3，将引导器具30设置在规定位置。在图9(B)中，使椎体间间隔件10的外侧面11侧的腹侧面17的卡合部20与导轨部31卡合。在图9(C)中，使用推杆(未图示)按压内侧面12侧，沿着导轨部31插入椎体间间隔件10，在图9(D)中，将第一个椎体间间隔件10设置于规定位置。
之后，在图9的(E)中，拔出引导器具30，将导轨部31的较短的新的引导器具30设置在椎体之间的规定位置。在图9(F)中，使椎体间间隔件10的内侧面12侧的腹侧面17的卡合部20与导轨部31卡合。在图9(G)中，使用推杆(未图示)按压外侧面11侧，沿着导轨部31插入椎体间间隔件10，在图9(H)中，将第二个椎体间间隔件10设置于规定位置，将引导器具30拔出。
通过将实施例2的导轨部31与位于椎体间的腹侧的椎间板的纤维环接触而设置，成为腹侧的壁，能够防止椎体间间隔件穿破纤维环而由椎体间向腹侧脱落。
图10示意性地示出使用实施例3的引导器具30而将2个椎体间间隔件10设置于椎体之间的步骤。实施例3的引导器具30与实施例2的引导器具30不同，与形成于椎体间间隔件10的背侧面18的卡合部20卡合。由此，神经3被引导器具30保护。
图11是示意性地表示椎体间间隔件10与引导器具30的导轨部31的卡合状态的具体例的图。在图11(A-1)中，导轨部31的截面为T字状的凸形状，相对的椎体间间隔件10的卡合部20的截面为T字状的凹形状。在图11(A-2)中，其相反。
图11(B-1)和图11(B-2)的卡合构造是燕尾槽，图11(C-1)和图11(C-2)的卡合构造是滚珠与插座的关系。它们的卡合具有各自的特征，T字形状和燕尾槽形状具有加工成本有利且能够可靠地保持的特征，在滚珠-插座形状中，滑动性变得良好。
图11(D)是图11(A-1)的变形，导轨部31的横向宽度与椎体间间隔件的腹侧面和/或背侧面的高度相比，极端地变小，即使在椎体间的狭窄区域，也能够将椎体间间隔件10更容易且准确地设置于规定的位置。
本国际申请是主张基于2019年8月30日申请的日本专利申请特开2019-157595号的优先权，将日本国专利特愿2019-157595号的全部内容引用于本国际申请。
产业上的可利用性
本发明的系统是简单的系统，若使用该系统，则即使在狭窄的手术区域中，也能够容易地将椎体间间隔件准确地设置于椎体间的规定的位置。
符号说明
1:椎体
1A：头侧椎体
1B：尾侧椎体
2:椎间板
3:神经
10:椎体间间隔件
11:外侧面
12:内侧面
13:上表面
14:下表面
15:中间部
16:骨移植部
17:腹侧面
18:背侧面
20:卡合部
30:引导器具
31:导轨部
32:把持部

Claims (6)

1.一种系统，是用于治疗脊椎疾病的系统，其特征在于，
该系统包括：
插入椎体与椎体之间使用的沿水平方向弯曲的椎体间间隔件，该椎体间间隔件具备：腹侧面，其具备与各所述椎体抵接的一对抵接面，在腹侧连接该一对抵接面，在俯视时为凸状的腹侧的侧面；及背侧面，其在背侧连接该一对抵接面，在俯视时为凹状的背侧的侧面，在所述腹侧面和/或背侧面具有沿着所述弯曲的方向的卡合部，以及
引导器具，其将所述椎体间间隔件引导至所述椎体与所述椎体之间的规定位置，在远端侧具有与所述腹侧面或背侧面中的任一个卡合部嵌合的导轨部，该导轨部在俯视时的曲率半径与所述腹侧面或所述背侧面在俯视时的曲率半径实质相同，
所述卡合部及所述导轨部的横截面中的任一方是凹形状，另一方是与所述凹形状对应的凸形状，所述凹形状具有比与所述凸形状对置的该凹形状的开口宽度宽的最大宽度的部分。
2.根据权利要求1所述的系统，其特征在于，
所述导轨部的横向宽度为在所述椎体间间隔件的所述腹侧面和/或所述背侧面的高度以下。
3.根据权利要求1或2所述的系统，其特征在于，
所述卡合部的横截面为T字状的凹形状，所述导轨部的横截面为T字状的凸形状。
4.根据权利要求1或2所述的系统，其特征在于，
所述卡合部的横截面为T字状的凸形状，所述导轨部的横截面为T字状的凹形状。
5.一种椎体间间隔件，其特征在于，是权利要求1至4中任一项所述的椎体间间隔件。
6.一种引导器具，其特征在于，是权利要求1至4中任一项所述的引导器具。
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Family Cites Families (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE29901611U1 (de) * 1999-01-30 1999-04-22 Aesculap Ag & Co Kg Chirurgisches Instrument zum Einführen von Zwischenwirbelimplantaten
FR2897259B1 (fr) * 2006-02-15 2008-05-09 Ldr Medical Soc Par Actions Si Cage intersomatique transforaminale a greffon de fusion intervetebrale et instrument d'implantation de la cage
US7500991B2 (en) * 2002-12-31 2009-03-10 Depuy Acromed, Inc. Banana cage
US7806932B2 (en) * 2003-08-01 2010-10-05 Zimmer Spine, Inc. Spinal implant
US20080133017A1 (en) * 2004-11-15 2008-06-05 Disc-O- Tech Medical Technology Assembled Prosthesis Such as a Disc
US20060142858A1 (en) * 2004-12-16 2006-06-29 Dennis Colleran Expandable implants for spinal disc replacement
US7591853B2 (en) * 2005-03-09 2009-09-22 Vertebral Technologies, Inc. Rail-based modular disc nucleus prosthesis
EP1752116A1 (de) * 2005-08-11 2007-02-14 Sepitec Foundation Intervertebralimplantat
JP4489051B2 (ja) * 2006-05-16 2010-06-23 タキロン株式会社 人工椎間板挿入治具
US8034110B2 (en) * 2006-07-31 2011-10-11 Depuy Spine, Inc. Spinal fusion implant
KR20120013940A (ko) * 2009-04-15 2012-02-15 신세스 게엠바하 가요성 추체간 스페이서용 척추 임플란트 시스템
JP5643305B2 (ja) 2009-07-09 2014-12-17 アール ツリー イノベーションズ エルエルシー 可撓性を有する椎体間装置
US8801793B2 (en) * 2011-01-18 2014-08-12 Warsaw Orthopedic, Inc. Interbody containment implant
US20120277866A1 (en) * 2011-04-28 2012-11-01 Prakasam Kalluri Angled Bullet-Nose Banana Cage
US9278008B2 (en) 2012-05-30 2016-03-08 Globus Medical, Inc. Expandable interbody spacer
WO2014033651A1 (en) * 2012-08-29 2014-03-06 Nlt Spine Ltd Method and system for implants
US9795494B2 (en) * 2012-12-03 2017-10-24 Meditech Spine, Llc Spinal implant alignment guide systems
KR101496304B1 (ko) * 2014-03-17 2015-02-26 김현성 최소 침습 추간체 고정 보형재 삽입장치
EP3103417B1 (en) * 2015-06-10 2018-01-31 Biedermann Technologies GmbH & Co. KG Intervertebral implant and system of an intervertebral implant and an instrument for inserting the intervertebral implant
ITUA20164406A1 (it) 2016-06-15 2017-12-15 Medacta Int Sa Dispositivo ed un kit per il posizionamento di un impianto di fusione intervertebrale
JP7067977B2 (ja) 2018-03-16 2022-05-16 株式会社Lixil 建具

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CA3137178A1 (en) 2021-03-04
EP3939547A1 (en) 2022-01-19
GB2598230B (en) 2023-06-07
CA3137178C (en) 2022-07-19
JP6700511B1 (ja) 2020-05-27
WO2021038982A1 (ja) 2021-03-04
EP3939547B1 (en) 2023-11-08
GB2598230A (en) 2022-02-23

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