JP2001526083A - 脊椎外科手術用スペーサ組立品 - Google Patents
脊椎外科手術用スペーサ組立品Info
- Publication number
- JP2001526083A JP2001526083A JP2000525053A JP2000525053A JP2001526083A JP 2001526083 A JP2001526083 A JP 2001526083A JP 2000525053 A JP2000525053 A JP 2000525053A JP 2000525053 A JP2000525053 A JP 2000525053A JP 2001526083 A JP2001526083 A JP 2001526083A
- Authority
- JP
- Japan
- Prior art keywords
- end cap
- spacer
- side wall
- spacer assembly
- extending
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
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
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
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- A—HUMAN NECESSITIES
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- 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
- A61F2/30721—Accessories
- A61F2/30744—End caps, e.g. for closing an endoprosthetic cavity
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- A—HUMAN NECESSITIES
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- 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
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-
- A—HUMAN NECESSITIES
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- 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
- A61F2/4455—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
- A61F2/4465—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 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
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- 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
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- 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
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-
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- 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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
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- 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
- A61F2/28—Bones
- A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
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- A—HUMAN NECESSITIES
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- 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
- A61F2002/30108—Shapes
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- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30113—Rounded shapes, e.g. with rounded corners circular
- A61F2002/30115—Rounded shapes, e.g. with rounded corners circular circular-O-shaped
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- A—HUMAN NECESSITIES
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- 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
- A61F2002/30108—Shapes
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- 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
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- 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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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
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- A—HUMAN NECESSITIES
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- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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- A61F2230/0017—Angular shapes
- A61F2230/0026—Angular shapes trapezoidal
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- A—HUMAN NECESSITIES
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- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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- A—HUMAN NECESSITIES
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- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0069—Three-dimensional shapes cylindrical
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0026—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in surface structures
-
- 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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
-
- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F28—HEAT EXCHANGE IN GENERAL
- F28F—DETAILS OF HEAT-EXCHANGE AND HEAT-TRANSFER APPARATUS, OF GENERAL APPLICATION
- F28F2265/00—Safety or protection arrangements; Arrangements for preventing malfunction
- F28F2265/26—Safety or protection arrangements; Arrangements for preventing malfunction for allowing differential expansion between elements
Landscapes
- Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurology (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Cardiology (AREA)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
Description
組立品に関する。最も詳しくは、本発明は脊椎外科手術で使用されるスペーサ用
の端部キャップに関する。
る。椎体間融合処置は、外科用メッシュ管の効用を利用する。例えば、“Chapte r 10: Titanium Surgical Mesh for Vertebral Defect Replacement and Interv ertebral Spacers”, Gary L. Lowery及びJurgen Harmsと、“Manual of Intern al Fixation of the Spine”, John S. Thalgott及び Max Aebi編集、,Lippinco ll-Raven Publishers, Philadelphia,1996年とを参照されたい。これらの文
献は参照によってここに編入される。外科用メッシュ管は整形的処置において弱
い骨組織の補強に使用され、また脊椎の構造支持体として働く。さらに、従来の
外科用メッシュ管のメッシュ模様は、該管内で骨が成長及び融合するためのアク
セスを提供する。そのような外科用メッシュ管はしばしばチタニウムから形成さ
れ、種々の形状及び寸法のものが入手可能である。また、外科用メッシュ管は、
各患者に対してより良く個々に適合するように、外科医によって現場でトリムす
ることができる。
例えば、“Titanium Surgical Mesh for Vertebral Defect Replacement and In tervertebral Spacers”, Gary L. Lowery及びJurgen Harmsと、“Manual of In ternal Fixation of the Spine”,John S. Thalgott 及び max Aebi編集、 Lipp incoll-Raven Publishers, Philadelphia,1996年を参照されたい。指摘し た論文で既に論じられたように、従来の環はねじを用いて一定の形状のメッシュ
に取り付けられる。従来の環は、補強材として働くことによって外科用メッシュ
管を補強し、該外科用メッシュ管の縁によってこれまで全体的に吸収されていた
軸方向の負荷を良好に分散させる助けとなる。
ペーサ組立品は、対向する両端部及び該両端部間に延びる側壁部を有するスペー
サと、該スペーサの両端部の少なくとも一方の端部に結合する少なくとも一つの
端部キャップとを含む。各端部キャップは、スペーサに対面する内端部、外端部
、及び内端部と外端部との間に延びる側壁部を有する。端部キャップの側壁部は
、スペーサの側壁部との係合のために形成されており、それによって端部キャッ
プとスペーサとが合体する。
内端部が該通路内に延びる。端部キャップの側壁部は外端部から内端部に向けて
収束することで、スペーサ内に端部キャップが楔状に係合する。また、端部キャ
ップは側壁部に結合した少なくとも一つの突起部を有し、該突起部はスペーサに
係合するように形成されている。突起部は、スペーサの通路内で端部キャップの
滑動を阻止する。また、外端部は、骨の内部成長を促す外面、例えば多孔性被膜
又は鋸歯状の面を有する。好ましくは、端部キャップ側壁部及び突起部とスペー
サ12の側壁部との係合によって端部キャップとスペーサとの間に単独の機械的
連結が得られる。
有するように形成される。スロットは、端部キャップがスペーサの通路に挿入さ
れるときに端部キャップの側壁部を圧縮することを可能とする。ひとたび通路内
に配置されると、側壁部はスペーサの側壁部方向に拡張し、端部キャップをスペ
ーサ内に摩擦係止する。スペーサとの係合のために圧縮可能な端部キャップの側
壁部から少なくとも一つの突起部が延びて、通路内での端部キャップの滑動を阻
止する。
側の端部を覆うように延びて外面に結合する。端部キャップは、外端部、内端部
、及び外端部と内端部との間に延びる側壁部を有する。また、側壁部は外端部と
内端部との間に延びるスロットを有する。スロットは、スペーサの端部の周りに
端部キャップの側壁部が配置されるときに該端部キャップの側壁部の拡張を可能
とする。ひとたびスペーサの外面のまわりに配置されると、端部キャップの側壁
部はスペーサの側壁部に向けて収縮し、スペーサの側壁部に端部キャップが摩擦
固定する。スペーサとの係合のための圧縮可能な端部キャップの側壁部から少な
くとも一つの突起部が延びて、通路内での端部キャップの滑動を阻止する。
善の様式で例示される好ましい実施形態例に関する以下の詳細な説明を検討する
ことによって当業者が容易に理解することができよう。
14において椎体スペーサ12とともに使用するために提供されて、スペーサ組
立体100を形成する。図1に示すように、端部キャップ10はスペーサ12と
結合し、脊椎14の前部18への配置に適している。この配置は、椎間板20の
置換又は椎体22の置換、あるいは各々の多数の変法に対して行うことができる
。
る。スペーサと脊椎14との間の動きを概ね無くすことで患者の痛みを和らげる
ために、スペーサ12と脊椎14とが融合するように、スペーサ12が骨(図示
せず)を収容する。スペーサ10は、対向する両端部24,26と、該端部24
,26との間に延び、かつ所定の内径28を持った通路32を規定する円筒状の
側壁部30とを有する。両端部24,26の各々は移動止め部38を形成する頂
部34と谷部36とを有する。また、側壁部30は内面40、外面42、及び内
面40と外面42との間に延在するアパーチャ44を有する。図2に示すように
、アパーチャ44は概ね菱形であり、かつ互いを基準にして菱様模様となるよう
に配置される。しかし、治癒プロセスの過程で骨の内部成長を促進させるために
、アパーチャ44を様々な形状及び寸法を有するものとしてよく、また種々のパ
ターンで配置されるものとしてもよいことが分かる。チタンメッシュに加えて、
端部キャップ10は、脊椎14の前部18でも使用されるスペーサの別の形態と
の使用に適している。特に、端部キャップ10は、様々な寸法で、かつ様々な金
属、複合体、組織、又は骨から構成されるメッシュスペーサとの使用、或いは脊
椎スペーサとして脊椎14に配置されるように設計された任意の別のタイプのメ
ッシュスペーサとの使用に適している。
た、脊椎14は、複数の椎体48から構成されるもので、そのうちの7個が頸椎
、12個が胸椎、5個が腰椎である。本発明の端部キャップ10は、頸椎、胸椎
、又は腰椎であろうとなかろうと脊椎14の前部18又は後部46に加えられる
スペーサ12と結合する。スペーサ12は、図1に示すように椎間板20又は椎
体48のいずれかと置換されるように設計することができる。
ために、端部キャップ10をスペーサ12の端部24,26のいずれにも結合す
る。端部キャップ10は、通路32の中に滑り落ちることなくスペーサ12の端
部24,26のいずれにもとどまる。図2乃至図5に示すように、端部キャップ
10は、外端部50、内端部52、及び外端部50から内端部52に向けて収束
(converging)するテーパ状の側壁部54を有するように形成されている。ここ
で図4を参照すると、側壁部54は一定の直径58を持つ概ね円筒状の内面56
を有し、また通路60及び外面62を規定する。図4及び図5に示す端部キャッ
プ10は概ね円形状の外側及び内側端部50,52を有するが、外側及び内側を
様々な形状に形成することでスペーサ12の様々な両端部24,26と相互作用
することができること、また互いに概ね平行に、又は互いを基準にして傾斜して
置かれるように配置されることもできることが分かる。また、端部キャップ10
は様々なスペーサ12と相互作用するように寸法を変えてもよいことが分かる。
て端部キャップ10とスペーサ12との間に摩擦係止部を形成するので、端部キ
ャップ10とスペーサ12とを合体させるために部材を追加する必要がない。こ
こで図4を参照すると、外面62は、外端部50に接した第1の外径64と内側
端部52に接した第2の外径66とを有する。図3に示すように、側壁部54の
外面62が約8度のテーパ勾配で収束するように、第1の外径64が第2の外径
66よりも大きい。本開示に基づいて端部キャップ10とスペーサ12との間に
摩擦係止部が形成される限り、側壁部54を種々の角度で形成してもよいことが
分かる。端部キャップ10の外端部50に接した側壁部54の第1の外径64は
概ねスペーサ14の直径28に等しく、外端部50がスペーサ12の端部24に
隣接して置かれるように配置される。
互いに離間した複数の突起部又は指状突起歯部(interdigitating teeth)78 を有するように、さらに形成されている。図6及び図7を参照すると、歯部78
が外面62に配置されており、端部キャップ10がスペーサ12の中にくい込む
と歯部78は両端部24,26の谷部36に係止する。各歯部78は移動止め部
38に係止するので、端部キャップ10がスペーサ12の通路32の中に滑り込
むのを防げる。側壁部54及び歯部78とスペーサ12の側壁部30との係合に
よって、端部キャップ10とスペーサ12との間に単独の機械的連結が与えられ
る。端部キャップが7枚の歯部78を持つものとして示されているが、7枚より
も多いか又は少ない数の歯部78を本開示に基づいて外面62に結合させてもよ
いことが分かる。
促進する外面68の一種として、例えば図11及び図12に示すような多孔性被
膜仕上げ69が挙げられる。骨の成長に適した他の外面68は、鋸歯状外面70
である。図1乃至図7を参照されたい。端部キャップ10の鋸歯状の面70は、
頂部74と谷部76とを含む。複数の頂部74と複数の谷部76とによって粗面
が与えられ、椎体48に対する動きが減少する。多孔性及び鋸歯状仕上げの外面
70を説明したが、骨の内部成長を促進する種々の横滑り防止面を本開示に基づ
いて使用してもよいことが分かる。
0又は椎体48を取り除いてスペース80を作る。例えば、図1の椎間板スペー
ス80を参照されたい。ひとたびスペース80が形成されると、外科医は適当な
寸法のスペーサ12と少なくとも一つの対応する端部キャップ10とを選択する
。一つの端部キャップ10とスペーサ12の端部24とについてのみ以下説明す
るが、説明及び請求の範囲が複数の端部キャップ10及び端部26についても適
用されることが分かる。図2を参照すると、端部キャップ10の内側端部52が
スペーサ12の端部24に位置合わせされる。スペーサ組立品100を形成する
ために外面62が押し込まれてスペーサの側壁部30に係合するまで、図7に示
すように、内端部52を通路32に挿入する。そのとき、歯部78は移動止め部
38の中に置かれるように配置され、スペーサ12の通路32の中を端部キャッ
プ10がさらに移動するのを防ぐ。ひとたび端部キャップ10がスペーサ12に
結合すると、種々の外科的方法を用いてスペーサ組立品100をスペース80に
挿入することができる。
。図8乃至図10を参照されたい。端部キャップ110は、側壁部30の形状が
楕円形であることを除いてスペーサ12と同一に形成される楕円形スペーサ(図
示せず)と協働作用するように形成される。端部キャップ110は端部キャップ
10と同様に形成され、同様の参照数字は同様の構成要素を示すのに使われる。
図8に示すように、端部キャップ110は外端部50に接した第1の環幅164
と内端部152に接した第2の環幅166とを有する。第1の環幅164は第2
の環幅166よりも大きいので、図9に示すように、側壁部54の外面62は外
端部50から内端部152に向けて収束して約8度のテーパ勾配を形成する。テ
ーパ勾配の角度は、端部キャップ110がスペーサ12に押し込まれることが可
能な限り変えてよいことが分かる。さらに、端部キャップ110は外面62に結
合した10個の歯部78を有する。しかし、10個よりも多いか、もしくは少な
い数の歯部78を外面62に結合させてもよいことが分かる。
ャップ210は端部キャップ10と同様に形成され、同様の参照数字は同様の構
成要素を示すのに使われる。図11及び図12に示すように、端部キャップ21
0は、外端部50に隣接した側壁部54から延びる単一の突起部又は外唇部28
2を有する。外唇部282は、外端部50の周縁に沿って延び、かつ両端部24
,26の各々の頂部34に係止することでスペーサ12の通路32に端部210
が滑り込むのを防ぐ内面284を有する。側壁部54及び歯状唇部282とスペ
ーサ12の側壁部30との係合によって端部キャップ210とスペーサ12との
間に単独の機械的連結がなされる。
図13及び図14に示すように、端部キャップ310は楕円形の一枚板(solid plate)358であり、骨粗鬆症骨用として特に適している。端部キャップ310
は、外端部350、内端部352、及び外端部350から内端部352に向けて
収束するテーパ状の側壁部354を有する。ここで図14を参照すると、側壁部
354は外面362を有する。側壁部354の外面362は外面62と同様にテ
ーパ状であり、スペーサ12と摩擦係止部を形成する。側壁部354とスペーサ
12の側壁部30との係合によって端部キャップ310とスペーサ12との間に
単独の機械的連結がなされる。また、アパーチャ360が外端部350と内端部
352との間に延びている。図13及び図14に概ね楕円形状の外端部350を
持つ端部キャップ10が示されているが、端部キャップ310は端部キャップ1
0と同様の形状又は種々のスペーサ12と相互作用するために種々の形状に形作
られてもよく、さらに(又は)アパーチャ360なしで形成されてもよいことが
分かる。端部キャップ10は種々のスペーサ12と相互作用するために寸法を変
えてもよいことも分かる。端部キャップ310は、外側歯部54、及び(又は)
外唇部56を有するように形成することが可能である。
外端部414と、内端部416と、該外端部414と内端部416との間に延在
する第1側壁部420及び第2側壁部429とを有する。第2の側壁部429は
、端部キャップ410をスペーサ12に挿入するのを促すように形成された面取
り部であり、また側壁部54と同様に第1の側壁部420から内端部416に向
けてテーパ状となっている。第2の側壁部429を図15に示す。第1の側壁部
420及び第2の側壁部429は通路422を規定する内面418を共有する。
第1の側壁部420は外面421も有し、一方第2の側壁部429は外面423
を有する。6個の歯部454が第1の側壁部420の周面に沿って延びており、
歯部78と同様にして外面421に結合している。歯部454は端部キャップ4
10がスペーサ12に深く入り込み過ぎるのを防ぐ。第1の側壁部420及び歯
部454とスペーサ12の側壁部30との係合によって端部キャップ410とス
ペーサ12との間に単独の機械的連結がなされる。歯部454の数は、本開示に
基づいて6枚よりも多く、又は少なくしてもよいことが分かる。また、外端部4
14及び内端部416が互いに概ね平行に置かれるように、或いは互いを基準に
して傾くように配置してもよいことが分かる。
426をさらに有し、該端部キャップ410が割環状となっている。断面端部4
24,426は、スロット又は切欠部428を規定する。端部キャップ410が
スペーサ12の通路32に挿入される際に、スロット428によって該端部キャ
ップ410が方向430に沿って圧縮可能となる。図15及び図16では端部キ
ャップ410が完全に開いた位置にあることを示しているので、下側の外径43
2(図17参照)は通路32の直径28よりも大きい。端部キャップ410は方
向430に沿って全体として圧縮されるにしたがって、スペーサ12の通路32
に挿入可能な寸法となる。ひとたびスペーサ12に挿入されると、端部キャップ
410が元の形状及び寸法に復元してスペーサ12の内面40を押圧し、固定及
び密な係合が確実となる。
0はほとんどすべての点において端部キャップ410と同一であり、同様の参照
数字は同様の構成要素を示すのに使われる。端部キャップ510は、外面414
に結合し、側壁部420から延びる歯部554を有する。したがって、外端部4
14は骨内部成長にとってさらに確実に固定がなされるように織地表面仕上げ(
textured)が施されている。
キャップ610は、端部キャップ410に類似して形成されており、同様の参照
数字は同様の構成要素を示すのに使われる。端部キャップ610は、外端部41
4と内端部416との間に延びる通路622を有するように形成されている。通
路622は、第1の側壁部420及び第2の側壁部429の内面632の表面積
が最大となるように不規則形状となっている。図19及び図20に示すように、
内面632は互いに離間した複数のポケット634を規定する。湾曲したポケッ
ト634を持つ不規則形状の通路622を有する端部キャップ610が図示かつ
説明されているが、端部キャップ610は本開示に基づいて任意の数の形状及び
寸法を持つ通路を有するように形成されてもよいことが分かる。
キャップ710は、端部キャップ410に類似して形成されており、同様の参照
数字は同様の構成要素を示すのに使われる。端部キャップ710は、内端部71
4と外端部716との間に延びる側壁部720を有する。側壁部720は、面取
り部を持たないで形成されている。また、図25及び図26に示すように、内端
部714及び外端部716は、互いを基準にして所定の角度731で置かれるよ
うに配置されており、また異なる面730,732、例えば多孔性の面69及び
鋸歯状の面70を有するように形成されている。図23及び図24に示すように
、端部710はアパーチャ734を有するもので、該アパーチャ734はスペー
サ12の通路32に挿入される方向430に沿って端部キャップを圧縮するため
の器具(図示せず)を受ける。側壁部720はテーパ状ではないので、外科医は
内端部714又は外端部716のいずれかを通路32に挿入することができ、そ
れによって所望の面69,70が椎体48との係合のために通路32とは反対側
の方向に向けられる。本開示に基づいて内端部及び外端部が互いを基準にして種
々の角度で配置されてもよく、また同様に概ね平行な関係に置かれるように配置
されてもよいことが分かる。
810を示す図である。端部キャップ810は、既に説明した端部キャップ10
,110,210,310,410,510,610及び710のように通路3
2に係合する代わりに、スペーサ12の外面42上に取り付けられる。端部キャ
ップ810は、外端部814、内端部816、及び外端部814と内端部816
との間に延びる三日月形側壁部820を有する。端部キャップが円形、楕円形、
又は任意の複雑な多項式(complex polynominal)形状に形作られてもよいことが
分かる。
有する。突起部又は唇部854は外端部814に隣接した側壁部820の周面に
沿って設けられ、かつ通路822の中に延びる。唇部854は、端部キャップ8
10がスペーサ12の中に深く入り込み過ぎるのを防ぐ。唇部854の数は、本
開示に基づいて複数であってもよいことが分かる。また、外端部814及び内端
部816が互いに概ね平行に置かれるように配置されてもよく、或いは互いを基
準にして傾斜していてもよいことが分かる。
28を規定する内部断面端部824,826も有する。スロット828は、内面
818がスペーサ12の側壁部30の外面42のまわりに延びる寸法となるよう
に、端部キャップ810を方向830に広げる。ひとたびスペーサ12の端部2
4のまわりに配置されると、端部キャップ810は図27に示す元の形状及び寸
法に向けて圧縮し、それによってスペーサ12の外面42を押圧して固定及び密
な係合を確実にする。軸方向の負荷に耐えるように、唇部854はスペーサ12
の端部24に接する。また、唇部は、端部26に対して端部キャップ810がス
ペーサ12の側壁部30のまわりにくぼみを作ることができないように、歯部7
8が与えたと同様の支持を与える。側壁部820及び唇部854とスペーサ12
の側壁部30との係合によって端部キャップ810とスペーサ12とが単独の機
械的連結をなす。
10,710及び810は、脊椎外科手術で使われるスペーサ組立品を形成する
ために、スペーサと相互作用するように形成される。端部キャップ10,11,
210,310,410,510,610,710及び810は、剪断力に対す
る抵抗性及び安定性を高めるために脊椎及び損傷外科手術で使用されるスペーサ
を補強する。本発明の端部キャップはスペーサの中に、スペーサの外側に、又は
スペーサを覆って適合し、テーパ勾配によって、又は割環力(split-ring force s)によってスペーサに結合する。端部キャップ10,11,210,310,4
10,510,610,710及び810は、好ましくはスペーサ12内に、又
はスペーサ12上に自己ロックする。また、本発明の端部キャップは種々のスペ
ーサ形状に適合するように種々の異なる多様形状(polynominal shapes)に形づ
けられ、また種々の表面被膜又は織地表面仕上げを有することで骨の成長又を促
したり、或いは滑り止め機能を持つことで骨に対する動きを防いで安定性を高め
る。少なくとも一つの突起部が端部キャップからスペーサに延びることで端部キ
ャップがスペーサ本体の通路内に滑り込むのを防ぐ。
び改善は請求の範囲に記述及び規定したように本発明の範囲及び精神の範囲内で
ある。
成するために脊椎から除去された一つの椎体の一部と該椎体空間内に広がる寸法
となった椎骨間スペーサとが示されている図である。
ャップとを有するスペーサ組立品が示されている図である。
るテーパ状の側壁部、該側壁部から外側方向に延びる複数の歯部、及び鋸歯状の
面を持つ外端部を有する端部キャップが示されている図である。
離間した関係にある複数の歯部とを有する側壁部が示されている図である。
ある。
り、端部キャップが鋸歯状の側面と該端部キャップの周面に沿って離間した複数
の歯部とを有し、かつスペーサに係合することで該端部キャップが所定の位置に
保持されることを示している図である。
部を有し、また2つの端部キャップは該通路内に延び、かつ円筒状側壁部に係合
することでスペーサと端部キャップが緊密にくさび止めされることが示されてい
る図である。
ップが楕円形状であることが示されている図である。
部と、内端部と、外端部から内端部に向けて収束するテーパ状の側壁部とを有す
ることが示されている図である。
であり、該端部キャップは多孔性被膜が形成された上面と外科用メッシュ管の通
路内を端部キャップが滑り落ちるのを防ぐために端部キャップの周縁に沿って延
びる唇部とを有することが示されている図である。
と、スペーサの通路に該端部キャップが滑り込むのを防ぐように側壁部の頂部に
係合している歯部とが示されている図である。
ーチャが形成された一枚板を組み込むための端部キャップが示されている図であ
る。
の間に延びるアパーチャが破線で示されている図である。
形成された側壁部と該側壁部に結合した複数の歯部とを有する端部キャップが示
されている図である。
めに端部キャップの外端部と内端部との間に延びるスロットが示されている図で
ある。
の側壁部とを有する側壁部が示されている図である。
内端部と、外端部と内端部との間に延びる側壁部と、側壁部から遠ざかるように
して外端部から上方向に延びる歯部とを有する端部キャップが示されている図で
ある。
路を規定する不定形の内面とを持つ側壁部を有する端部キャップが示されている
図である。
する側壁部の内面が示されている図である。
トが示されている図である。
の側壁部とを有する側壁部が示されている図である。
しで形成された側壁部を有する端部キャップが示されている図である。
パーチャを有する外端部が示されている図である。
側端部及び内側端部が示されている図である。
側端部及び内側端部が示されている図である。
端部を覆って係合するように元の形状から広がるように形作られた三日月形の側
壁部を有する端部キャップが示されている図である。
通路に延びる唇部とを有する側壁部が示されている図である。
ある。
ップ 12 スペーサ 14 脊椎 18 前部 20 椎間板 22,48 椎体 24,26 端部 28 内径 30,720 側壁部 32,622,822 通路 34,74 頂部 36,76 谷部 38 移動止め部 40,418,632 内面 42,62,68,423 外面 44 アパーチャ 46 後部 50,414,716,814 外端部 52,152,416,714,816 内端部 54 テーパ状の側壁部 56 円筒状内面 58 直径 64 第1の外径 66 第2の外径 69 多孔性被膜の面 70 鋸歯状の面 78 歯部 80 スペース 100 スペーサ組立品 164 第1の環幅 166 第2の環幅 282 外唇部 358 一枚板 420 第1の側壁部 424,426 内部断面端部 428,828 切欠部(スロット) 429 第2側壁部 454,554 歯部 730,732 面 820 三日月形側壁部 824,826 内部断面端部 854 唇部
Claims (34)
- 【請求項1】 脊椎外科手術で使用されるスペーサ組立品であって、該組立
品は、 対向する両端部と該両端部間に延びる側壁部とを有するように形成されたスペ
ーサと、 前記両端部の少なくとも一方に結合した少なくとも一つの端部キャップとを備
え、前記少なくとも一つの端部キャップは、前記スペーサに対面する内端部と、
外端部と、前記内端部と前記外端部との間に延びる側壁部とを有し、前記スペー
サの前記側壁部と係合することで前記少なくとも一つの端部キャップと前記スペ
ーサとの間が機械的に連結されるスペーサ組立品。 - 【請求項2】 前記スペーサは前記対向する両端部間に延びる通路を有し、
前記端部キャップの前記内端部が前記通路に延びる請求項1に記載のスペーサ組
立品。 - 【請求項3】 前記端部キャップの前記側壁部が前記外端部から前記内端部
に向けて収束する請求項2に記載のスペーサ組立品。 - 【請求項4】 前記端部キャップは、前記端部キャップの前記側壁部に結合
し、かつ前記スペーサに係合するために形成された突起部を有する請求項3に記
載のスペーサ組立品。 - 【請求項5】 前記外端部は、多孔性被膜を有するように形成されている請
求項3に記載のスペーサ組立品。 - 【請求項6】 前記外端部は、鋸歯状の面を有するように形成されている請
求項3に記載のスペーサ組立品。 - 【請求項7】 前記端部キャップは、前記端部キャップから遠ざかるように
延びて前記スペーサと係合する請求項2に記載のスペーサ組立品。 - 【請求項8】 前記端部キャップは、互いに離間し、かつスペーサとの係合
のために形成された突起部を有する請求項2に記載のスペーサ組立品。 - 【請求項9】 前記端部キャップの側壁部は前記外端部と前記内端部との間
に延びるスロットを有する請求項2に記載のスペーサ組立品。 - 【請求項10】 前記端部キャップは、前記スペーサと係合するために形成
された互いに離間した突起部を有する請求項9に記載のスペーサ組立品。 - 【請求項11】 前記スペーサの前記側壁部は外面を有し、前記端部キャッ
プの側壁部が該外面と結合する請求項1に記載のスペーサ組立品。 - 【請求項12】 前記端部キャップの前記側壁部は、前記外端部と前記内端
部との間に延びるスロットを有する請求項11に記載のスペーサ組立品。 - 【請求項13】 前記端部キャップの前記側壁部は通路を規定し、また前記
端部キャップは前記側壁部の前記通路に延びるとともに前記スペーサに係合する
少なくとも一つ突起部を有する請求項12に記載のスペーサ組立品。 - 【請求項14】 前記端部キャップの前記側壁部は、前記内端部と前記外端
部との間の通路を規定する内面を有する請求項1に記載のスペーサ組立品。 - 【請求項15】 前記側壁部の前記内面は概ね円筒状の形状を有する請求項
14に記載のスペーサ組立品。 - 【請求項16】 前記端部キャップは外面と内面との間に延びるアパーチャ
ーを有する一枚板として形成されている請求項1に記載のスペーサ組立品。 - 【請求項17】 前記スペーサの少なくとも一つの端部は、頂部と谷部とを
有する請求項1に記載のスペーサ組立品。 - 【請求項18】 前記端部キャップは、前記端部キャップの前記側壁部に結
合し、かつ前記頂部間に延びるとともに前記スペーサの谷部に係合するように形
成された突起部を有する請求項17に記載のスペーサ組立品。 - 【請求項19】 前記端部キャップは、前記端部キャップの前記側壁部に結
合し、かつ前記スペーサの頂部に係合するように形成された突起部を有する請求
項17に記載のスペーサ組立品。 - 【請求項20】 脊椎外科手術で使用されるスペーサ組立品であって、該組
立品は、 対向する両端部と該両端部間に延びる側壁部とを有するように形成されたスペ
ーサと、 前記両端部の各々に結合した端部キャップとを備え、前記端部キャップの各々
は、前記スペーサに対面する内端部と、外端部と、前記内端部と前記外端部との
間に延びる側壁部と、該側壁部から延びる少なくとも一つの突起部とを有し、前
記端部キャップの前記側壁部が前記スペーサの前記側壁部と係合し、前記少なく
とも一つの突起部が前記スペーサの各々反対側の端部の側壁部と係合することで
、前記スペーサと前記端部キャップとの間が単独に機械的に連結されるスペーサ
組立品。 - 【請求項21】 両端部は、頂部及び谷部を含むように形成される請求項2
0に記載のスペーサ組立品。 - 【請求項22】 前記少なくとも一つの突起部は、各々の前記両端部の少な
くとも一つの頂部に係合する請求項21に記載のスペーサ組立品。 - 【請求項23】 前駆少なくとも一つの突起部は、各々の前記両端部の少な
くとも一つの谷部に係合する請求項21に記載のスペーサ組立品。 - 【請求項24】 前記スペーサは、前記両端部間に延びる通路を有し、前記
端部キャップの前記内端部が前記通路に延びる請求項20に記載のスペーサ組立
品。 - 【請求項25】 前記端部キャップの前記側壁部は、前記外端部と前記内端
部との間に延びるスロットを有する請求項24に記載のスペーサ組立品。 - 【請求項26】 前記端部キャップの前記側壁部がテーパ状である請求項2
4に記載のスペーサ組立品。 - 【請求項27】 前記スペーサの前記側壁部は外面を有し、前記端部キャッ
プの前記側壁部が前記外面に結合する請求項20に記載のスペーサ組立品。 - 【請求項28】 前記端部キャップの前記側壁部は前記外端部と前記内端部
との間に延びるスロットを有する請求項27に記載のスペーサ組立品。 - 【請求項29】 前記端部キャップの前記外端部の形状が概ね円形である請
求項20に記載の端部キャップ。 - 【請求項30】 前記端部キャップの前記外端部は骨成長を促すために形成
された被膜を有する請求項20に記載の端部キャップ。 - 【請求項31】 前記端部キャップの前記側壁部は通路を規定する概ね円筒
状の内面を有する請求項25に記載の端部キャップ。 - 【請求項32】 対向する両端部を持つスペーサ組立品とともに脊椎外科手
術において使用するために形成された端部キャップであって、 内端部と、外端部と、前記内端部と前記外端部との間に延びる側壁部と、前記
側壁部から延びる少なくとも一つの突起部とを有し、前記側壁部は前記端部キャ
ップと前記スペーサとが合体するように前記端部キャップと前記スペーサとを機
械的に連結することに適している端部キャップ。 - 【請求項33】 前記側壁部が通路及び外面を規定する内面を有する請求項
32に記載の端部キャップ。 - 【請求項34】 前記側壁部の前記内面の形状が概ね円筒形である請求項3
3に記載の端部キャップ。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US6866097P | 1997-12-23 | 1997-12-23 | |
US60/068,660 | 1997-12-23 | ||
PCT/US1998/027476 WO1999032055A1 (en) | 1997-12-23 | 1998-12-23 | Spacer assembly for use in spinal surgeries |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2001526083A true JP2001526083A (ja) | 2001-12-18 |
JP4097896B2 JP4097896B2 (ja) | 2008-06-11 |
Family
ID=22083948
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2000525053A Expired - Lifetime JP4097896B2 (ja) | 1997-12-23 | 1998-12-23 | 脊椎外科手術用スペーサ組立品 |
Country Status (9)
Country | Link |
---|---|
US (2) | US6086613A (ja) |
EP (1) | EP1041946B1 (ja) |
JP (1) | JP4097896B2 (ja) |
KR (1) | KR20010033466A (ja) |
CN (1) | CN1253130C (ja) |
AU (1) | AU734942B2 (ja) |
CA (1) | CA2313467C (ja) |
DE (1) | DE69822508T2 (ja) |
WO (1) | WO1999032055A1 (ja) |
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Also Published As
Publication number | Publication date |
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US20020068978A1 (en) | 2002-06-06 |
CA2313467C (en) | 2007-10-09 |
AU734942B2 (en) | 2001-06-28 |
US6776798B2 (en) | 2004-08-17 |
AU2093699A (en) | 1999-07-12 |
CN1253130C (zh) | 2006-04-26 |
US6086613A (en) | 2000-07-11 |
DE69822508T2 (de) | 2005-01-05 |
EP1041946A1 (en) | 2000-10-11 |
WO1999032055A1 (en) | 1999-07-01 |
KR20010033466A (ko) | 2001-04-25 |
JP4097896B2 (ja) | 2008-06-11 |
DE69822508D1 (de) | 2004-04-22 |
EP1041946B1 (en) | 2004-03-17 |
CN1283090A (zh) | 2001-02-07 |
CA2313467A1 (en) | 1999-07-01 |
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