JP2004528868A - 骨修復手段 - Google Patents

骨修復手段 Download PDF

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Publication number
JP2004528868A
JP2004528868A JP2002558867A JP2002558867A JP2004528868A JP 2004528868 A JP2004528868 A JP 2004528868A JP 2002558867 A JP2002558867 A JP 2002558867A JP 2002558867 A JP2002558867 A JP 2002558867A JP 2004528868 A JP2004528868 A JP 2004528868A
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bone
tube
mesh
healthy
graft
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JP2002558867A
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JP4112366B2 (ja
Inventor
ヴァンサン プランティラール
ギュイ ドヌヴィレール
セバスティヤン ムリオ
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クザン ビオテク
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    • A61F2/2846—Support means for bone substitute or for bone graft implants, e.g. membranes or plates for covering bone defects
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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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • 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
    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/02—Materials or treatment for tissue regeneration for reconstruction of bones; weight-bearing implants

Abstract

本発明は、関節固定術による骨修復手段に関する。本発明の手段は、その内部に移植骨（２）が挿入される、ポリ‐Ｌ‐乳酸により被覆された広幅網の網目組織のチューブ（１）を包含し、前記チューブ（１）が、健康な骨部（Ｖ）にネジ（４）で固定されたプレート（３）により該位置に保持されることを特徴とする。本発明は、骨の空洞の充填に対して有用である。

Description

【技術分野】
【０００１】
本発明は関節固定術による骨修復手段であり、外傷を受けた骨、特に頚椎骨の再生に用いることを目的とするものである。
【背景技術】
【０００２】
脊椎の疾病の手術処置においては、執刀医が一つまたはそれ以上の椎体の、部分的または全体的な切除を行う。従前まで切除された骨によって与えられていた機械的支持はもはや失われる。この不利点を克服するために、一般的にはチタンからなる脊椎ロッドを用いる方法が知られており、骨切除後に残された空間は、不活性かつ生体適合性のある素材で充填される。脊椎ロッドは、充填されたセメント素材が硬化するまでの初期的な支持を行うために、二つの健康な脊椎体の間に挿入される。また、自家移植骨の単独ブロックが用いられ、もしくは骨銀行からの骨、あるいは骨代替物が用いられる。
【０００３】
もう一つの技術においては、前記ロッドおよび生体適合性のセメント素材の代わりに、骨切除後の空間を充填するために移植骨片が挿入され、骨部を支持する「椎体」と呼ばれる剛体の金属網を張った構造物が用いられる。ただし剛体の金属網の設置のために、隣接する椎骨を脇へ寄せざるをえず、手術により併発症を引き起こす。さらに、金属網はＸ線に対して不透過である。
【発明の開示】
【発明が解決しようとする課題】
【０００４】
本発明の第一の目的の一つは、上述の欠点を克服することである。
【課題を解決するための手段】
【０００５】
本発明による、外傷を受けた骨に対する骨移植による修復手段は、移植骨片を内部に挿入するものとして、生体吸収性素材で被覆された、生体適合性の広幅網の網目構造からなるチューブを包含することを特徴とする。
【０００６】
前記網目構造は、編物または織物または不織繊維のいずれをも指す。また生体吸収性であってもなくてもよい。前記チューブは骨空洞部の空間を充填するために設置される。ただし好ましくは、前記チューブは、健康な骨部にネジで固定されたプレートにより該位置に保持されるものであり、脊椎の場合には、チューブは上部および下部の各脊椎のプラトー部により該位置に保持される。
【０００７】
前記チューブは生体適合性で、生体吸収性または非生体吸収性の広幅メッシュの繊維素材からなる筒状である。前記被覆素材はポリ‐Ｌ‐乳酸（ＰＬＬＡ）の化合物、ポリグリコール酸またはその重合体の化合物である。移植骨の成長が網開口部を通して、切除により露出した健康な骨部方向に成長する間に、ポリ‐Ｌ‐乳酸（ＰＬＬＡ）は経時的に吸収される。移植骨と切除面の健康な骨部の壁との、望ましい密着性を維持するには、前記繊維チューブ単独では柔軟すぎるであろう。
【０００８】
ＰＬＬＡのような生体吸収性素材をコーティングすることにより、
・前記チューブを一定期間硬化し、
・前記チューブに対し適切な解剖学的形態を賦与し、
・術後初期の、移植骨の散逸を避けるために、移植骨の移動に対して前記チューブを密閉する、
ことが可能となる。
【０００９】
本発明のもう一つの特徴によると、脊椎の場合には、前記プレートはまた、端部が移植骨に埋め込まれた少なくとも一つのネジを手段として、移植組織を該位置に保持する機能を有する。
【００１０】
脊椎については、移植骨の充填または骨片の圧着が行われる該位置に前記チューブを設置するために必要な余地を残すために、腹側のルート経由で椎体の全体的または部分的な除去を行うことが知られている。前記プレートの目的は、構造体の良好な機械抵抗を支持することであり、また新生骨が硬化するまでの間、各骨間の正確に区切られた区画内に、充填物生成物を内包する前記チューブを保持することである。
【００１１】
前記移植骨の成長を追跡検査し、移植骨の定着をモニターするために、前記チューブはその組成からＸ線に対して透過性である。繊維からなる前記チューブは、単にハサミでカットし整形することで、脊椎間の形状に適合させられるであろう。ＰＬＬＡが吸収されると、前記移植骨は肋骨の壁方向に成長し、望ましい関節固定の形成に融合することができ、そして前記チューブが分解する。
【００１２】
本発明のその他の特徴及び利点は、非制限的な例として単に与えられる具体的な実施例について、図面を参照しつつ以下の記述により明確にされる。
【発明を実施するための最良の形態】
【００１３】
前記参照図面の双方において、同一の指示は同一の部位を示す。図１において、移植組織は、移植骨2を包含する概ね円筒形状のチューブ１で構成され、二つの健康な脊椎Ｖの間に挿入されていることを示す。
プレート３は前記チューブ１の長さに沿って適合され、前記プレート３は、部分的な椎体の切除を受けた上方および下方の各々の脊椎にネジ固定されている。プレート３はその両端を緊締ネジ４により該位置に保持され、ネジ４は二つの健康な脊椎Ｖに固定される。前記移植骨が、少なくとも一つのネジ５により、本例ではその中央部で、プレート３に連結される。本発明によれば、広幅メッシュ６は、一定期間の後に、前記移植骨の成長を可能にするために消滅する。また本図面においては、脊椎の横断方向および棘突起（言及しない）が示されている。図２は、椎体Ｖ1の断面内で所定位置に設置された移植組織の頭上方向からの図示である。本図においては脊柱管（言及しない）が模式化されている。プレート３の中央には、チューブ１を貫通し、チューブ１の所定位置の保持を支持して移植骨内に固定されたネジ５が示される。
【００１４】
上述の記載は脊椎に関するものであるが、本発明は、骨の空洞、特に切除に伴うものについて、二つの骨の間で欠損を充填できるあらゆる事例に適用されるものである。
疑いなく、種々の変形形態、特に代替物による同等の技術手段によって実施される変形形態は、本発明の適用範囲に含まれるものである。
【図面の簡単な説明】
【００１５】
【図１】部分的な側面図。切除を受けた脊椎の空洞内で、二つの健康な脊椎の間に配置される移植組織の縦断面図を示す。
【図２】部分的な切除を受けた脊椎の、頭上から見た水平断面図を示す。
【符号の説明】
【００１６】
１ チューブ
２ 移植骨
３ プレート
４ ネジ（プレートの固定用）
５ ネジ（移植骨の固定用）
６ 広幅網
Ｖ、Ｖ１ 脊椎

Claims (5)

  1. 外傷を受けた骨に対する、関節固定術による骨修復手段で、生体吸収性または非吸収性の、生体適合性の広幅網の網目構造からなるチューブ（１）を包含し、その内部に移植骨（２）が挿入されることを特徴とする骨修復手段。
  2. 請求項１の骨修復手段で、チューブ（１）が、ネジ（４）により健康な各骨部（Ｖ）に固定されたプレート（３）により、所定位置に保持されることを特徴とする骨修復手段。
  3. 請求項２の骨修復手段で、チューブ（１）がまた、端部が移植骨（２）中に埋め込まれた少なくとも一つのネジ（５）により、保持されることを特徴とする骨修復手段。
  4. 請求項１から３のいずれかの骨修復手段で、前記移植骨（２）が、圧着湿布様の骨片および／または骨代替物の構成からなることを特徴とする骨修復手段。
  5. 上述の各請求項のいずれかの骨修復手段で、生体吸収性の被覆素材がポリ‐Ｌ‐乳酸、および／またはポリグリコール酸および／またはそれらの共重合体であることを特徴とする骨修復手段。
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FR2819715A1 (fr) 2002-07-26
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ATE303748T1 (de) 2005-09-15
US20070073401A1 (en) 2007-03-29
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DE60206023T2 (de) 2006-06-22
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JP4112366B2 (ja) 2008-07-02

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