JP2002534156A - 移植部材 - Google Patents
移植部材Info
- Publication number
- JP2002534156A JP2002534156A JP2000591938A JP2000591938A JP2002534156A JP 2002534156 A JP2002534156 A JP 2002534156A JP 2000591938 A JP2000591938 A JP 2000591938A JP 2000591938 A JP2000591938 A JP 2000591938A JP 2002534156 A JP2002534156 A JP 2002534156A
- Authority
- JP
- Japan
- Prior art keywords
- bone
- implant
- support surface
- flexible
- space
- 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
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3683—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix subjected to a specific treatment prior to implantation, e.g. decellularising, demineralising, grinding, cellular disruption/non-collagenous protein removal, anti-calcification, crosslinking, supercritical fluid extraction, enzyme treatment
-
- 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
- A61F2/4455—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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- 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
- A61F2/447—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 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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- A—HUMAN NECESSITIES
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- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3604—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
- A61L27/3608—Bone, e.g. demineralised bone matrix [DBM], bone powder
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3641—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the site of application in the body
- A61L27/3645—Connective tissue
- A61L27/365—Bones
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3641—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the site of application in the body
- A61L27/3645—Connective tissue
- A61L27/3654—Cartilage, e.g. meniscus
- A61L27/3658—Intervertebral discs
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- A—HUMAN NECESSITIES
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- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3683—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix subjected to a specific treatment prior to implantation, e.g. decellularising, demineralising, grinding, cellular disruption/non-collagenous protein removal, anti-calcification, crosslinking, supercritical fluid extraction, enzyme treatment
- A61L27/3687—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix subjected to a specific treatment prior to implantation, e.g. decellularising, demineralising, grinding, cellular disruption/non-collagenous protein removal, anti-calcification, crosslinking, supercritical fluid extraction, enzyme treatment characterised by the use of chemical agents in the treatment, e.g. specific enzymes, detergents, capping agents, crosslinkers, anticalcification agents
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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
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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
- A61F2/30721—Accessories
- A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
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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
- A61F2/3094—Designing or manufacturing processes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
- A61F2/442—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
- A61F2/28—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
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- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30014—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
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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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- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
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Abstract
Description
らに、詳細には、本発明は、脊柱の固定に使用する、骨で形成された椎骨間用
固定装置に関する。
。これらの移植部材は、スチール、チタン、複合体、同種移植片、異種移植片ま
たは他の生物学上矛盾のない材料を含む種々の材料から製造することができる。
これらの移植部材は、周囲の神経及び血管構造を保護するために固定された保護
管を使用して、また保護されない開放手順を通して挿入される。椎間板のスペー
スに挿入される装置の寸法についての1つの制限は、椎間板のスペースに接近す
るために使用することができる周囲の組織を通る開口の寸法である。脊柱に後方
から接近する方法において、椎間板のスペースに接近するために硬膜及神経根を
動かさなければならない。同様に、前方から接近する方法において、大動脈及び
大静脈を移動しなければならない。このような移動は、解剖学的な構造によって
しばしば制限され、椎間板のスペースの寸法と比較する際に接近する場所が非常
に小さいものとなる。椎間板のスペースへの入口を拡大するために靱帯及び骨を
さらに拡大することによって2つの隣接する椎骨間の結合が不安定になるか、弱
くなる。さらに、大きな接近用の開口をつくるために血管及び神経構造を過剰に
後退させることは、これらの組織を損傷するおそれがある。したがって、これま
での手順は、脊柱の一方の側の利用可能な開口を通して通過可能な第1の装置を
配置し、脊柱の他の側に他の同様な移植部材を配置するために組織または血管を
動かすことが制限されていた。各移植片は、利用可能な接近場所によって寸法が
制限される。
盾のない材料から開発されてきた。これらの装置は、それらが椎間板のスペース
に配置された後、拡張を可能にする移植材料のヒンジまたは選択的な変形に依存
する。このような装置は、小さい挿入構造及び拡張したスペース構成を有するが
、移植部材を形成するために使用される材料は、合成物であり、隣接する骨組織
に組み込まれない。骨は大きく改良された組み込みを提供するが、鉱物の高い含
有量から本来の骨のもろい性質を生じ、特に負荷を支持する皮相骨は、変形の可
能性を大きく制限する。通常、例えば、皮相骨は、ほぼ70%の鉱物、30%の
非鉱物の割合から成る。非鉱物の内容では、90%はI型のコラーゲンであり、
細胞質物質と非コラーゲンたんぱく質とのバランスがとられている。
状化された鉱物質が除去された骨として使用される。層状化される骨移植片の1
つの形態は、非常に小さい構造的な完全性を有するスポンジまたは化粧用パフの
ような形態の鉱物質が除去された骨材料である。骨の構造的な特性は、骨の内部
成長を支持するために適しているタンパク質を保持しているが、鉱物質の内容物
を除去することによって交換えることができる。したがって、このような骨のス
ポンジ及び化粧用パフは、負荷を支持する用途には使用されない。
骨移植部材は、第1の骨部分と、第2の骨部分と、この第1の骨部分と第2の骨
部分を接続する可撓性骨部分と、を有する。中間の可撓性骨部分は、第2の骨部
分に対して第1の骨部分の動きを可能にする。好ましい実施形態において、第1
及び第2の骨部分の動きは、所望ならば、2つの骨構造を間隔を置いた関係で維
持し、小さい寸法形状の挿入形状と骨の成長を可能にするために適した拡張形状
との間で行われる。選択的には、第1と第2の骨部分との間の運動は、装置が隣
接する骨構造との間に配置されるとき弾性ダンパとして使用される。
性部分をつくる鉱物質の少なくとも一部が除去された領域を有する骨部分を有す
る。1つの実施形態において、皮層大腿部リング部分の反対側は、椎間板のスペ
ースに挿入されたときにリング部分が拡張されるように作用する。他の実施形態
において、装置は、骨部分の反対側に鉱物質が除去された少なくとも2つの部分
を有する。この構成において、ほぼ剛性の部分は、可撓性部分が弾性機能を実行
し、さらに正常な動きまたは椎間板のスペースに隣接してさらによい骨の支持を
するように2つの隣接する骨構造の間で負荷支持面に接触するように配置される
。
部分を提供し、この部分の中間部分を形成する。この中央部分は、2つの隣接す
る骨部分の間に可撓性部材をつくるために少なくとも一部の鉱物質が除去される
。2つの隣接する骨部分の間の骨の部分の少なくとも一部の鉱物をが除去する方
法は、移植の所望の構造をつくるために必要なほど繰り返される。
る。特に、本発明は、挿入管と、可撓性の中央部分によって接続された第1及び
第2の部分を有する骨から形成された移植部材とを提供することを含む。この挿
入管は、椎骨を隣接させることによって形成された椎間板のスペースに隣接する
ように配置される。骨移植部材の第1及び第2の部分は、挿入管に挿入するため
に小さい寸法に配置される。移植部材は、管に挿入され、それが挿入管に配置さ
れるまで前進する。移植部材が所望の位置に到達するとき、第1及び第2の部分
は、可撓性部分を拡張された移植形状にたわませることによって互いに関して移
動される。挿入方法の好ましい実施形態において、穴内成長材料は、穴内成長を
固定装置に、また固定装置の周りに促進するために第1と第2との部分の間に配
置される。
に基づいて当業者に明らかになる。
の実施形態を説明するために特別の言語を使用する。本発明の範囲を制限するこ
と意図されず、図示した装置の変形例及び他の変更例が考慮され、図示したよう
な本発明の原理の他の用途が当業者によって考慮されることは理解できよう。
発明の移植部材は多数の用途を有するが、図1に示す実施形態は、脊柱の椎体間
の固定を促進するようになっている。特に、図1は、第1の剛性部分12と、第
2の剛性部分14とを有する骨移植部材10を示している。第1と第2との剛性
部分12及び14は、中間部分16によって結合される。中間部分16は、骨移
植部材10の可撓性領域をつくるために一部の鉱物質が除去されている。好まし
くは、中間部分16の領域は、最大限の可撓性を支持するために鉱物質が完全に
除去される。中間部分16の鉱物質を除去することによってつくられた可撓性に
よって剛性部分を互いに移動することができる。この特徴の利点は、以下に説明
する。
えている。同様に、骨部分14は、上方支持面15に形成された骨係合突起部1
8と、底部支持面(図示せず)に形成された同一の突起部19とを有する。突起
部は、好ましい実施形態で示されているが、椎間板の空隙から抜けることを制限
するために椎体に有効に係合する表面を提供する種々の構造が考慮される。
提供するようになっている。特に、骨移植部材は、目的とする環境において用途
を見いだすために上面と下面との間の圧縮に十分に抵抗するドナー骨から選択さ
れる。剛性の骨部分のついは、隣接する椎骨の間の空隙において支持体を提供す
るために協働する。本発明の移植部材の好ましい実施形態は、2つの剛性の骨部
分を備え、他の移植部材の形状を提供するために可撓性骨領域によって相互に接
続されるている。
発明による装置を挿入する方法が示されている。特に、図2を参照すると、移植
部材10は、第2の部分14に隣接するように第1の部分12が配置され、小さ
い寸法の挿入構成で示されている。図2に示すように、剛性の部分は、ほぼ平行
に整列して配置されている。しかしながら、ある用途によれば、中間部分16の
この量の可撓性は必要ではない。好ましい実施形態において、移植部材は、挿入
管30内で挿入形状で拘束されている。
本発明から逸脱することなくいかなる方向からも接近を達成することができるが
、説明を目的とし、制限を目的としない観点において、図2及び図3は、後方か
らの接近について可能である。接近が行われると、保護スリーブは、椎間板の空
隙に隣接して配置され、必要である場合には、椎間板の空隙は延伸される。小さ
い寸法の構成において、移植部材は、保護スリーブ30内に配置され、椎間板の
スペースDに向かって前進する。移植部材は配置した後、さらに大きな寸法を有
するが、硬膜34は、保護スリーブ30と小さい寸法の移植部材を通過させるこ
とができるように十分なほどキャビティ38内で延伸される。
)に入るまで押し込み装置(図示せず)を使用することによって保護スリーブ3
0を介して前進される。一端椎間板のスペースDに到達したとき、装置は、中央
部分12に形成された弾性変形部分または分離器具(図示せず)を解放すること
によって装置が拡張し、各部分の間の動きを押して装置を図3に示す拡張したス
ペース構成にする。装置の拡張は、移植部材の性質を、広い支持面積を介して椎
間板のスペースへの大きな安定性と椎間板のスペースでぐらつく傾向を小さくす
る。さらに部分12と14との間のキャビティ33は、骨の組み合わせ及び固定
を促進する材料を受ける領域を提供する。移植部材10が適当に配置されると、
移植部材10への骨の成長を促進するために第1の部分12と第2の部分14と
の間に骨成長促進材料32が配置されている。図示はしないが、さらに安定性を
提供するために椎間板のスペースDに第2の移植部材が配置されることは理解で
きよう。
の間に形成された椎間板のスペースDの高さに等しい高さHを有する。この実施
形態において、高さHは、図3に示す挿入から図4に示す拡張形状まで一定であ
る。さらに、図2に均一な高さの移植部材が示されているが、移植部材10は、
移植部材が脊柱の適当な前湾の曲率を確立し維持するために使用することができ
るようなテーパの高さを有する。剛性の骨部分14を参照すると、上方支持面2
5は、上方の椎体38を係合しこれを支持し、下方支持面27は下方支持体36
に移植部材に係合しこれを支持する。突起部18及び19は、移植部材が抜けな
いように椎体38及び36の表面に係合する。椎体に同様に係合する剛性の骨部
分12に関連して剛性骨部分14は、高さHを維持し、脊柱に加えられる正常な
力に耐える剛性と構造的な完全性を有する。可撓性領域16は、このような構造
的な要求を必要とはしないが、好ましくは、2つの支持壁の間の接続を維持する
ことによって移植部材の安定性を得る補助とする。
すなわち、小さい寸法の挿入形状と拡張したスペース形状とを有する自然の骨か
ら成る特徴を提供する。
するが、移植部材の反対側の中央部分16の幅は、図2の挿入形状から図3の拡
張形状に容易に拡張可能である。この特徴は、小さいアクセス場所を通しての挿
入を可能にし、椎間板の空隙の移植部材の安定性を増大する。
ている。図5は、本発明によって変形された皮層骨ドエル50を示す。骨ドエル
50は、隣接する椎骨に係合し、移植部材を制御された方法で前進し、抜けるこ
とを防止するねじ58を含む。移植部材50は、装置を回転する駆動器具に係合
する凹部が形成されたスロット64を有する。本発明によれば、ねじが形成され
た骨ドエル50は、上述したように可撓性領域56とスロット62によって第1
の側壁52と第2の側壁54とに分割される。可撓性領域56は、移植部材のこ
の領域で骨の無機質を除去することによってつくられる。第1及び第2の側壁5
2及び54の各々は、上方及び下方支持面を含む。この開口部は、骨幹骨の自然
の骨随によって、またはドナー骨の海綿骨質を除去することによって除去される
が、これはドナー骨の形状に依存する。
椎間板のスペースに挿入される。上方及び下方の椎体に隣接して開口60が配置
されると、第1の側壁52及び第2の側壁54は、可撓性部分56でたわむ移植
部材によって互いに離れる。移植部材50は、図7に拡張した状態が示されてい
る。所望の拡張が行われると、骨成長促進材料64は、第1の側壁52と第2の
側壁54の間の内側領域60に挿入される。側壁は、椎間板のスペースの高さを
維持するために構造的な支持体を提供する。図5ないし図7を参照すると、骨移
植部材50は、小さい寸法の挿入形状と拡張したスペース形状とを有する。
エルの変形例が示されている。特に、骨移植部材80は、鉱物質が少ない2つの
領域を含み、移植部材にある程度の可撓性を提供する。鉱物質が除去された部分
86及び88は、突起部分82と84との間に配置される。したがって、突起部
分82または84に加えられる力の突然の変化は、介在する可撓性領域によって
減衰される。図8を参照すると、装置は、椎体V1及びV2に隣接して配置され
た突起部分92及び94を備えた椎体V1と椎体V2との間の椎間板のスペース
94に移植される。力が椎体V1及びV2に加えられるとき、鉱物質が除去され
た移植部材にある程度可撓性を提供し生理学的な負荷的な環境を提供する。特に
、矢印102、103、104及び105によって示された圧縮力は、可撓性部
分86及び88を部分110及び112にたわませることによってさらによく伝
達される。このような装置は、固定(正常な負荷)及び関節形成術(正常な動き
)の双方での用途を有する。
大腿部のリングのような内側のキャビティ30を有するリング形状の骨部分であ
る。リング120に溝128が形成されている。溝128の反対側の部分126
は、鉱物質の少なくとも一部を除去するように処理されている。これは、部分1
26で可撓性領域をつくる。したがって、骨は、スロット128と可撓性部分1
26によって側壁122と124に分割される。前述したように、骨移植片は、
側壁124を側壁122から離れるように動かすことによって挿入後拡張される
。
ーサ180は、通常、脊柱の頸部領域で使用される。スペーサ180は、壁18
2,183,184及び191によって画定された内側キャビティ188を含む
。スペーサ188は、隣接する椎骨の間の固定を促進するために骨移植材料を受
けるために適している。拡張を行うために、壁183の開口186がつくられ、
反対側に、少なくとも鉱物質の一部を除去することによって壁191に可撓性ヒ
ンジ領域190がつくられる。このように壁182及び184は、隣接する椎骨
の間に挿入した後矢印192及び194の方向に移動され、移植部材を拡張する
。壁191は拡張処理の間に少なくとも一部が変形される。
において、スペーサ195は、壁199,200、201によって形成された内
側室208を有する。壁201は貫通するように形成された開口196を有する
骨の可撓性領域は、壁199の接続部分に隣接した壁200及び202のヒンジ
領域197及び198で少なくとも一部の鉱物質を除去することによってつくら
れる。壁200及び202は、スペーサ195の拡張を可能にするように矢印2
04及び206の方向に移動する。移植部材の2つのヒンジを使用することによ
って椎間板のスペースの壁199に正確に配置することができ、拡張中に壁19
9の一部の配置を換えることなく側方に拡張することができる。
となく、必要な移植部材の間隔にさらに密接に適合するためにドナー用骨部分を
成形することができる。いくつかの場合において、ドナー骨部分は、移植場所の
形状と互換性のある形状を有する。これらの骨部分は、その意図した用途にさら
に緊密に合致するように骨移植部材を成形するために可撓性を有する領域を有す
る。このような部分は、ドナー骨部分の形状全体が可撓性部分でたわむことによ
って変形されるように1つまたは複数の可撓性を有する領域を有する。これは移
植部材の負荷支持強度を保存する。本発明のこの実施形態は、ドナー骨の制限さ
れた供給源の潜在的に使用可能な部分を増大する。ドナー骨及び他の移植部材の
形状の完全な利用は、1998年10月29日に出願され、「IMPACTED BONE IMPLANTS A
ND INSTRUMENTATION」と題された米国特許出願第09/181,353号にその全体が示さ
れている。
ってドナー骨を処理することを含む。このようなドナー骨は、人間からの同種移
植片または動物からの異種移植片を含む。さらに、骨移植分野における技術が進
歩するにしたがって、骨成長によって、または骨の構成部分を処理し、骨に非常
に類似した特性を有する人工の材料をつくることによってドナー骨を形成する。
さらに詳細には、利用可能な同種または異種の骨の在庫をこの手順で使用するこ
とができるが、移植可能な装置の特別の要求に依存して皮相海綿骨質または海綿
骨質を使用することができる。
ルまたはヒドロゲンパーオキサイドのような用材を用いてきれいに洗浄され、脂
肪が除去される。次にこの骨は、くさび形、ドエルまたは他の形状の最終的な形
状をつくるために従来の技術を使用して機械加工されるか、成形される。骨の中
間部分は、可撓性を増大する必要に応じて形成される。可撓性の能力を必要とす
る場所で鉱物質を除去する処理が行われる。鉱物質を除去する液体を可撓性を有
する所望の領域に隣接する骨に浸透させる処理は、流体静水学的な圧力によって
制御され、鉱物質を除去する領域を制限する。骨から除去された鉱物の量は、可
撓性の所望な量をつくるために調整することができる。これは、従来のようなヒ
ドロクロリック、ニトリルまたはシトリル酸のような有機酸を使用する。好まし
くは、鉱物質を除去する0.1ないし1.0NHClを有し、最も好ましくは0.3
NHClを有する。もし、異種移植片が使用される場合には、骨のたんぱく質を不活
性にし、アンチゲネシティを低減する有機溶剤の使用についての公知の技術をこ
の点に使用する。さらに、グルタールアルデヒドは、ミネラル部分の除去に続い
てコラーゲン構造をクロスラインのために使用される。装置は機械加工され、一
部が鉱物質を除去するとき、挿入前に記憶される。
することができる。 図面を詳細に図示し、説明したが、説明のためであり、制限を目的とするもの
ではない。当業者は本発明の精神または範囲を逸脱せずに変更改造を行うことが
できる。
る。
Claims (29)
- 【請求項1】 第1の骨部分と、第2の骨部分と、前記第1の骨部分と前記
第2の骨部分とを接続する可撓性骨部分と、を有し、前記可撓性骨部分は、前記
第2の骨部分に関して前記第1の骨部分を移動することができる、移植部材。 - 【請求項2】 前記可撓性骨部分は、鉱物質の少なくとも一部が除去された
骨である請求項1に記載の移植部材。 - 【請求項3】 前記可撓性骨部分は、鉱物質を完全に除去された骨である請
求項1に記載の移植部材。 - 【請求項4】 前記第1の部分は、第1の高さによって分離された上方支持
面と下方支持面とを有し、前記第2の骨部分は、第2の高さによって分離された
上方支持面と下方支持面とを有し、前記第1の高さ及び第2の高さは、隣接する
骨の間にスペースを維持する請求項1に記載の移植部材。 - 【請求項5】 前記第1の高さと第2の高さは、ほぼ等しい請求項4に記載
の移植部材。 - 【請求項6】 前記上方支持面及び下方支持面は、2つの隣接する椎骨の間
の椎間板のスペースから移植部材が抜けることを防止するための骨係合面を有す
る請求項4に記載の移植部材。 - 【請求項7】 前記移植部材は、脊柱固定装置であり、前記第1と第2の骨
部分は、第1の椎体と第2の椎体との間に所望のスペースを維持する請求項1に
記載の移植部材。 - 【請求項8】 前記第1と第2の骨部分は、第1の端部から反対側の端部に
次第に増加するスペースの高さを有する移植部材を提供するために対応するテー
パを有する支持面を有する請求項7に記載の移植部材。 - 【請求項9】 前記第1の骨部分、第2の骨部分、及び前記可撓性骨部分は
、単一の骨部分から形成されている請求項1に記載の移植部材。 - 【請求項10】 第1の支持面と第2の支持面との間に延びる皮層骨部分を
有する骨部分を有し、前記骨部分は、前記第1の支持面と第2の支持面との間に
可撓性部分をつくるために少なくとも一部の鉱物質が除去されている移植部材。 - 【請求項11】 前記骨部分は、リング形状の骨部分であり、前記骨部分は
、前記可撓性部分の反対側に溝を有し、前記溝は、前記骨部材を前記溝と前記可
撓性部分との間に延びる第1の部分と前記溝と前記可撓性部分との間に延びる反
対側の第2の部分とに分割する請求項10に記載の移植部材。 - 【請求項12】 前記第1の支持面は、上方椎体に係合し、前記第2の支持
面は、隣接する下方の椎体に係合し、前記可撓性部分は、力を伝達するために前
記第1と第2の支持面との間に配置されており、前記可撓性部分は、ショックア
ブソーバとして作用する請求項10に記載の移植部材。 - 【請求項13】 第1の椎体に係合する第1の支持面を有する第1の骨部分
と、 第2の椎体に係合する第2の支持面を有する第2の骨部分と、 前記第1の骨部分と前記第2の骨部分との間に配置された少なくとも1つの可
撓性部分とを有し、前記可撓性部分は、前記第1の骨部分と第2の骨部分との間
で移動することができる、隣接する第1と第2との椎体の間のスペースに挿入さ
れる脊柱固定用移植部材。 - 【請求項14】 前記第1の骨部分は、前記第1の支持面と反対側の第3の
支持面を有し、前記第2の椎体と前記第2の骨部分に係合する前記第3の支持面
は、前記第2の支持面と反対側の第4の支持面を有し、前記第4の支持面は、前
記第1の椎体に係合し、前記第1と第2の骨部分は、前記第1と第2との間にス
ペースを維持するように協働する請求項13に記載の脊柱固定用移植部材。 - 【請求項15】 可撓性部分は、前記第1と第2の椎体との間にショクアブ
ソーバとして機能する請求項13に記載の脊柱固定用移植部材。 - 【請求項16】 前記移植部材は、近位端と反対側の遠位端とを有し、前記
可撓性部分は、前記近位端に隣接して配置されている請求項13に記載の脊柱固
定移植部材。 - 【請求項17】 前記遠位端に隣接して配置されるとともに前記第1の骨部
分と第2の骨部分との間に延びる第2の可撓性部分を有する請求項16に記載の
移植部材。 - 【請求項18】 前記第1の支持面と前記第2の支持面は、前記第1と第2
の椎体との間のスペースに前記移植部材のねじによる挿入が可能になるように協
働するねじが形成されている請求項17に記載の移植部材。 - 【請求項19】 前記移植部材は、骨の単一部分から形成される請求項15
に記載の移植部材。 - 【請求項20】 剛性の骨部分を提供することと、 前記骨部分の中間部分を形成することと、 前記剛性の骨の隣接する部分との間で可撓性部分をつくるために骨の中間部分
の鉱物質の少なくとも一部を除くことと、を有する可撓性骨移植部材を形成する
方法。 - 【請求項21】 前記鉱物質の少なくとも一部を除去することは、前記中間
部分を鉱物質を除去する液体に露出する請求項20に記載の方法。 - 【請求項22】 前記鉱物質の液体と中間部分に隣接する骨との接触を制限
することを含む請求項21に記載の方法。 - 【請求項23】 前記骨の接触を制限することは、骨の鉱物質を除く液体を
中間部分に隣接する骨へ移動することを制限するために静水力学的な圧力を使用
する請求項22に記載の方法。 - 【請求項24】 前記移植部材に骨係合表面を形成することを含む請求項2
0に記載の方法。 - 【請求項25】 前記の骨係合面は、前記移植部材の動きを防止するように
構成する請求項24に記載の方法。 - 【請求項26】 挿入管と骨から形成されるとともに第1部分、第2の部分
及び前記第1の部分及び第2の部分を接続する中央の可撓性部分を有する移植部
材とを形成することと、 2つの椎骨の間の椎間板のスペースに隣接して挿入管を配置することと、 前記挿入管に前記移植部材を挿入することと、 前記移植部材を前記挿入管を通して前記椎間板のスペースに前進させることと
、 前記第2の部分に対して前記第1の部分を移動させることと、を有する骨から
つくられた椎体間用固定移植部材を挿入する方法。 - 【請求項27】 少なくとも一部が小さい挿入形状から拡張したスペース形
状に可動な骨移植部材を形成することと、 前記移植部材を前記小さい挿入形状にすることと、 前記移植部材を小さい挿入形状で椎間板のスペースに配置することと、 前記挿入部材を前記拡張されたスペース形状で配置することと、を有する脊柱
のスペース用の骨移植部材を移植する方法。 - 【請求項28】 前記移植部材は、少なくとも一部が弾性を有し、前記移動
は、圧縮装置で前記移植部材を圧縮することを含む請求項27に記載の方法。 - 【請求項29】 前記移植部材を配置することは、前記移植部材を小さい挿
入形状で受ける内側通路を有する管によって達成される請求項28に記載の方法
。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/227,976 US6206923B1 (en) | 1999-01-08 | 1999-01-08 | Flexible implant using partially demineralized bone |
US09/227,976 | 1999-01-08 | ||
PCT/US2000/000154 WO2000040179A1 (en) | 1999-01-08 | 2000-01-05 | Flexible implant using partially demineralized bone |
Publications (3)
Publication Number | Publication Date |
---|---|
JP2002534156A true JP2002534156A (ja) | 2002-10-15 |
JP2002534156A5 JP2002534156A5 (ja) | 2006-07-13 |
JP4282239B2 JP4282239B2 (ja) | 2009-06-17 |
Family
ID=22855238
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2000591938A Expired - Fee Related JP4282239B2 (ja) | 1999-01-08 | 2000-01-05 | 移植部材 |
Country Status (9)
Country | Link |
---|---|
US (3) | US6206923B1 (ja) |
EP (1) | EP1139929B1 (ja) |
JP (1) | JP4282239B2 (ja) |
AT (1) | ATE262866T1 (ja) |
AU (1) | AU747356B2 (ja) |
CA (1) | CA2358455A1 (ja) |
DE (1) | DE60009446T2 (ja) |
ES (1) | ES2215606T3 (ja) |
WO (1) | WO2000040179A1 (ja) |
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DE19807236C2 (de) | 1998-02-20 | 2000-06-21 | Biedermann Motech Gmbh | Zwischenwirbelimplantat |
US6193757B1 (en) | 1998-10-29 | 2001-02-27 | Sdgi Holdings, Inc. | Expandable intervertebral spacers |
-
1999
- 1999-01-08 US US09/227,976 patent/US6206923B1/en not_active Expired - Fee Related
-
2000
- 2000-01-05 AU AU24054/00A patent/AU747356B2/en not_active Ceased
- 2000-01-05 ES ES00902318T patent/ES2215606T3/es not_active Expired - Lifetime
- 2000-01-05 DE DE60009446T patent/DE60009446T2/de not_active Expired - Fee Related
- 2000-01-05 JP JP2000591938A patent/JP4282239B2/ja not_active Expired - Fee Related
- 2000-01-05 EP EP00902318A patent/EP1139929B1/en not_active Expired - Lifetime
- 2000-01-05 CA CA002358455A patent/CA2358455A1/en not_active Abandoned
- 2000-01-05 AT AT00902318T patent/ATE262866T1/de not_active IP Right Cessation
- 2000-01-05 WO PCT/US2000/000154 patent/WO2000040179A1/en active IP Right Grant
-
2001
- 2001-02-02 US US09/776,590 patent/US20010010021A1/en not_active Abandoned
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2003
- 2003-06-30 US US10/609,857 patent/US6913621B2/en not_active Expired - Fee Related
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2006134813A1 (ja) * | 2005-06-14 | 2006-12-21 | Olympus Biomaterial Corp. | 骨補填材導入具およびその作動方法ならびに骨補填材 |
Also Published As
Publication number | Publication date |
---|---|
ATE262866T1 (de) | 2004-04-15 |
US20040002760A1 (en) | 2004-01-01 |
EP1139929B1 (en) | 2004-03-31 |
AU2405400A (en) | 2000-07-24 |
DE60009446T2 (de) | 2005-01-27 |
WO2000040179A1 (en) | 2000-07-13 |
US20010010021A1 (en) | 2001-07-26 |
EP1139929A1 (en) | 2001-10-10 |
US6206923B1 (en) | 2001-03-27 |
JP4282239B2 (ja) | 2009-06-17 |
AU747356B2 (en) | 2002-05-16 |
CA2358455A1 (en) | 2000-07-13 |
DE60009446D1 (de) | 2004-05-06 |
ES2215606T3 (es) | 2004-10-16 |
US6913621B2 (en) | 2005-07-05 |
WO2000040179B1 (en) | 2000-10-12 |
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