JP2006513795A - 椎間インプラント用の固定手段 - Google Patents
椎間インプラント用の固定手段 Download PDFInfo
- Publication number
- JP2006513795A JP2006513795A JP2004570451A JP2004570451A JP2006513795A JP 2006513795 A JP2006513795 A JP 2006513795A JP 2004570451 A JP2004570451 A JP 2004570451A JP 2004570451 A JP2004570451 A JP 2004570451A JP 2006513795 A JP2006513795 A JP 2006513795A
- Authority
- JP
- Japan
- Prior art keywords
- intervertebral implant
- central axis
- fixing
- cavity
- fixation
- 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
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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
- A61F2/30728—Collars; Bone edge protectors
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- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F01—MACHINES OR ENGINES IN GENERAL; ENGINE PLANTS IN GENERAL; STEAM ENGINES
- F01C—ROTARY-PISTON OR OSCILLATING-PISTON MACHINES OR ENGINES
- F01C1/00—Rotary-piston machines or engines
- F01C1/02—Rotary-piston machines or engines of arcuate-engagement type, i.e. with circular translatory movement of co-operating members, each member having the same number of teeth or tooth-equivalents
- F01C1/063—Rotary-piston machines or engines of arcuate-engagement type, i.e. with circular translatory movement of co-operating members, each member having the same number of teeth or tooth-equivalents with coaxially-mounted members having continuously-changing circumferential spacing between them
- F01C1/067—Rotary-piston machines or engines of arcuate-engagement type, i.e. with circular translatory movement of co-operating members, each member having the same number of teeth or tooth-equivalents with coaxially-mounted members having continuously-changing circumferential spacing between them having cam-and-follower type drive
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- H—ELECTRICITY
- H01—ELECTRIC ELEMENTS
- H01Q—ANTENNAS, i.e. RADIO AERIALS
- H01Q1/00—Details of, or arrangements associated with, antennas
- H01Q1/27—Adaptation for use in or on movable bodies
- H01Q1/32—Adaptation for use in or on road or rail vehicles
- H01Q1/325—Adaptation for use in or on road or rail vehicles characterised by the location of the antenna on the vehicle
- H01Q1/3291—Adaptation for use in or on road or rail vehicles characterised by the location of the antenna on the vehicle mounted in or on other locations inside the vehicle or vehicle body
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- H—ELECTRICITY
- H01—ELECTRIC ELEMENTS
- H01Q—ANTENNAS, i.e. RADIO AERIALS
- H01Q17/00—Devices for absorbing waves radiated from an antenna; Combinations of such devices with active antenna elements or systems
-
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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
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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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- 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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- 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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Abstract
Description
米国特許第5,683,465号明細書(特許文献1)により椎間板エンドプロテーゼが周知であるが、これは1つの実施形態において、インプラントの外側に隣接したカバープレートによって実施される隣接した椎体の終板へのピンによって固定される。このピンのこうした固定手段における不利点は、椎間腔への椎間板エンドプロテーゼの導入前にピンをカバープレートに固定しなければならず、これはインプラントの椎間腔への導入に際して両方の椎体の骨延長の拡大を必要とし、またはその他の場合、椎間腔へのインプラントの導入後にピンを個別に隣接する椎体の終板へ圧入しなければならず、これは結果として手術時間の増大をもたらしうることである。
本発明による固定手段は、椎体の終板への椎間インプラントの固定のために使用され、かつ実質的に中心軸を有する固定部であって、中心軸の方向に固定部を貫通する空洞、および中心軸に対して横方向に立つ2つの端面、椎体の終板へ圧入可能である端面上に突出する少なくとも2つのスパイク、およびそれによって固定部がスパイクといっしょに椎間インプラントにおいて着脱式にロック可能である固定手段を有する固定部を含んで成る。
本発明によって達成される利点は、実質的に本発明による固定手段のおかげで、
−椎間腔への椎間インプラントの移植に際して2つの隣接した椎体の最小限の骨延長のみが必要であり、かつ
−椎間インプラントが本発明による固定手段によって簡単に椎間インプラントに接する椎体へ固定可能である点において確認される。
固定手段は、例えば、固定部の中心軸に対して横方向に椎間インプラントにかみ合わせ可能かつ弾性に変形可能であり、中心軸に対して横方向に固定部へ挿入またはネジ込み可能であり、または空洞と椎間インプラントとの間のコーン接続によって実施されうる。
好ましい実施形態においては、固定手段は固定部の中心軸に対して横方向に弾性に変形可能であり、かつ変形されていない状態で固定部の空洞へ突出する。弾性に変形可能な固定手段は、固定部が一塊状に製造可能であり、かつ構成要素を失う危険が回避されうるという利点を有する。
好ましくは、これらの固定手段は、中心軸に向けられた突出部を有するフックとして形成されている。
さらに別の実施形態においては、フックは、中心軸に対して横方向に変形されていないフックの場合、フックの突出部が空洞へ接触し、中心軸に対して横方向に変形されたフックの場合、中心部へ向けられたその突出部を含めて窪みで受入れ可能であるように中心軸に対して平行の空洞壁の窪みへかみ合わせされている。
別の実施形態においては、固定部は環状に形成されており、ここで中心軸に対して直交の空洞の横断面および/または外側被覆面によって画定され、かつ中心軸に対して直交の固定部の横断面は、円形面、楕円面、卵形面、または多角面でありうる。
本発明による椎間インプラントの好ましい実施形態においては、これは2つの軸方向の末端の閉鎖プレートを含んで成るが、その外側の表面は2つの隣接する椎体のカバープレート、もしくはベースプレート、および2つの固定手段への取付けのために使用される。閉鎖プレートは固定部の空洞を通じて通過され、固定部は閉鎖プレートに対して軸方向に移動可能でありうる。それによって、
−椎間腔への椎間インプラントの導入前に、スパイクが閉鎖プレートの末端の端面上に突出するまで固定部が軸方向に移動可能であり、したがって椎間腔への椎間インプラントの導入に際して隣接する椎体は最小限にしか広げる必要がなく、かつ
−椎間腔への椎間インプラントの導入後に、スパイクが隣接する椎体のベース、もしくはカバープレートへ圧入されるまで、両方の固定部が簡単な器具で移動可能であるという利点が達成可能である。
別の実施形態においては、閉鎖プレートは第2の固定手段を含んで成り、固定手段が固定部へかみ合わせ可能である。これら第2の固定手段は、例えば、椎間インプラントの閉鎖プレートが、フックに取付けられた突出部を受入れるために使用される、その被覆面において中心軸に対して平行の溝でありうる。溝の構成は、溝へかみ合わせした突出部によって閉鎖プレートが固定部に対するねじれが阻止されうるという利点を有する。
さらに別の実施形態においては、固定手段は固定部において椎間インプラントにおいて取付けられた第2の固定手段に対して遊びを有し、固定された固定手段において、閉鎖プレートに対して中心軸の周りの固定部の小さなねじれが可能とされるようになっている。 それによって、一定の範囲内で許容可能である隣接する椎体のねじれ運動が、固定部と椎間インプラントとの接続によって許容されるという利点が達成可能である。
さらに別の実施形態においては、第2の固定手段は、閉鎖プレートが軸方向に外側の、直径が削減された部分で形成されており、フックの突出部がかみ合わせしうるという点にある。
a)前外側、腹側外側、経腹腔、または腹膜後の外科的処置によって椎間腔への進入を可能にするステップと、
b)椎間腔に隣接する両方の椎体を延長するステップと、
c)椎間腔を空にするステップと、
d)互いに結合された固定手段とともに椎間インプラントを導入するステップ。それによって、両方の固定部は、スパイクが閉鎖プレートの外側の表面上にもはや突出しないまで互いに結合される。
e)スパイクが隣接する椎体のベース、もしくはカバープレートに十分に圧入されるまで固定部を軸方向に別々に移動させるステップと、
f)固定手段を椎間インプラントに固定するステップ。固定手段が弾性に実施されている場合、その固定は、固定部がその軸方向の最終位置に別々に移動次第、操作者のさらなる補助なしに自動的に行われる。しかし、固定手段がネジまたは同様の手段として形成されている場合、これは適切な器具で固定される必要がある。
本発明および本発明の発展形態を以下、複数の実施形態の部分的な概略図を用いてさらに詳しく説明する。
図1は、本発明による固定手段の実施形態を示す断面図である。
図2は、本発明による固定手段の図1に示されている実施形態を示す平面図である。
図3は、図1および2に示されている実施形態による椎間インプラントに配置された2つの固定手段を示す断面図である。
図4は、図1および2に示されている実施形態による移植可能な椎間インプラントおよび2つの固定手段とともに脊椎を示す断面図である。
図5は、図1および2に示されている実施形態による2つの固定手段とともに椎間インプラントを示す縦断面図である。
椎間インプラント15の空洞3への導入に際しては、フック10は窪み8へ曲がり、椎間インプラント15は中心軸6に対して平行に空洞3を通じて、突出部11のそばに摺動可能である。これは、例えば、固定部1’’において示されている。椎間インプラント15の閉鎖プレート13、14は、軸方向に末端で直径が削減された部分22を有し、フック10の突出部11は、閉鎖プレート13、14において削減された部分22によって形成される段部へかみ合わせしうる。それによって、閉鎖プレート13、14の外側の端面17が隣接する椎体のベースプレート、もしくはカバープレートに接することが達成可能である。したがって、固定部1の端面4は隣接する椎体に接しないため、椎間インプラント15のみが軸方向に荷重性であり、全端面17上の負荷が移送されることが保証されている。
8 窪み 9 固定手段 10 フック 11 突出部 12 空洞壁
13 閉鎖プレート 14 閉鎖プレート 15 椎間インプラント
16 外側被覆面 18 溝 19 椎体 20 椎体
21 固定手段 22 直径が削減された部分
Claims (16)
- 椎間インプラント(15)を椎体(19、20)の終板へ固定するための2つの固定手段(21)を有する椎間インプラント(15)であって、
A)各固定手段(21)が、中心軸(6)と前記中心軸(6)に対して横方向に立つ2つの端面(4、5)を含んで成る固定部(1)を含んで成り、
B)各固定手段(21)が、前記端面(4、5)を介して、前記中心軸(6)に対して平行に突出し、椎体(19、20)の終板へ圧入可能な少なくとも2つのスパイク(7)を含んで成る椎間インプラント(15)において、
C)前記固定部(1)が前記中心軸(6)に対して平行に貫通する空洞(3)を含んで成り、
D)前記固定部(1)が、それによって固定部が椎間インプラント(15)において着脱式にロック可能である固定手段(9)を含んで成り、
E)前記椎間インプラント(15)が末端でそれぞれ前記中心軸(6)に交差する閉鎖プレート(13、14)を含んで成り、かつ
F)前記閉鎖プレート(13、14)が前記空洞(3)を通じて前記固定部(1)へ貫通可能であることを特徴とする椎間インプラント(15)。 - 前記固定手段(9)が、前記中心軸(6)に対して横方向に弾性に変形可能であり、かつ変形されていない状態で前記空洞(3)に突出することを特徴とする請求項1に記載の椎間インプラント(15)。
- 前記固定手段(9)が、前記中心軸(6)へ方向づけされた突出部(11)とともに前記中心軸(6)に対して横方向に弾性に変形可能なフック(10)であることを特徴とする請求項2に記載の椎間インプラント(15)。
- 前記フック(10)が前記空洞(3)に配置されていることを特徴とする請求項3に記載の椎間インプラント(15)。
- 前記固定手段(9)および前記固定部(1)が一塊状であることを特徴とする請求項1〜4のいずれか一項に記載の椎間インプラント(15)。
- 前記空洞(3)が、その中に前記フック(10)が配置されている窪み(8)を含んで成ることを特徴とする請求項3〜5のいずれか一項に記載の椎間インプラント(15)。
- 前記窪み(8)が前記中心軸(6)に対して垂直に深さTを有し、かつ前記突出部(11)が前記中心軸(6)に対して垂直に測定して最大の長さLを有し、ここでL<Tであることを特徴とする請求項6に記載の椎間インプラント(15)。
- 前記固定部(1)が環状に形成されており、かつ前記空洞(3)の前記中心軸(6)に対して直交の横断面および/または前記固定部(1)の外側被覆面によって制限された前記中心軸(6)に対して直交の横断面が、円形面、楕円面、多角面、または卵形面であることを特徴とする請求項1〜7のいずれか一項に記載の椎間インプラント(15)。
- 末端でそれぞれ前記中心軸(6)に交差する閉鎖プレート(13、14)を含んで成り、かつ前記空洞(3)の形が前記閉鎖プレート(13、14)に適合されていることを特徴とする請求項1〜8のいずれか一項に記載の椎間インプラント(15)。
- 前記閉鎖プレート(13、14)が遊びなしに前記固定部(1)の前記空洞(3)に位置しており、かつ前記中心軸(6)に対して平行に移動可能であることを特徴とする請求項9に記載の椎間インプラント(15)。
- 前記固定部(1)が、前記閉鎖プレート(13、14)へ固定された固定手段(9)によって前記中心軸(6)の周りのねじれに対して遊びを有することを特徴とする請求項1〜8のいずれか一項に記載の椎間インプラント(15)。
- 前記閉鎖プレート(13、14)が第2の固定手段を含んで成り、前記固定手段(9)が前記固定部(1)へかみ合わせ可能であることを特徴とする請求項1〜11のいずれか一項に記載の椎間インプラント(15)。
- 外側被覆面(16)を有し、かつ第2の固定手段として前記固定手段(9)を部分的に受入れるために前記中心軸(6)に対して横方向に前記被覆面(16)へ貫入する溝(18)を含んで成ることを特徴とする請求項12に記載の椎間インプラント(15)。
- 前記閉鎖プレート(13、14)が軸方向に外側の、直径が削減された部分(22)を含んで成ることを特徴とする請求項1〜13のいずれか一項に記載の椎間インプラント(15)。
- 椎間の空間を削り落とすステップを特徴とする、請求項1から14のいずれか一項に記載の椎間の空間にインプラントを固定する方法。
- 椎間インプラント(15)を椎体(19、20)の終板へ固定するための2つの固定手段(21)を有する椎間インプラント(15)であって、
A)各固定手段(21)が、中心軸(6)と前記中心軸(6)に対して横方向に立つ2つの端面(4、5)を含んで成る固定部(1)を含んで成り、
B)各固定手段(21)が、前記端面(4、5)を介して、前記中心軸(6)に対して平行に突出し、椎体(19、20)の終板へ圧入可能な少なくとも2つのスパイク(7)を含んで成る椎間インプラント(15)において、
C)前記固定部(1)が前記中心軸(6)に対して平行に貫通する空洞(3)を含んで成り、
D)前記固定部(1)が、それによって固定部が椎間インプラント(15)において着脱式にロック可能である固定手段(9)を含んで成り、
E)前記椎間インプラント(15)が末端でそれぞれ前記中心軸(6)に交差する閉鎖プレート(13、14)を含んで成り、かつ
F)前記閉鎖プレート(13、14)が前記空洞(3)を通じて前記固定部(1)へ貫通可能であることを特徴とする椎間インプラント(15)。
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BR (1) | BR0318243A (ja) |
CA (1) | CA2529564A1 (ja) |
DE (1) | DE50308821D1 (ja) |
ES (1) | ES2297132T3 (ja) |
NZ (2) | NZ543434A (ja) |
WO (1) | WO2004089256A1 (ja) |
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FR2869528B1 (fr) | 2004-04-28 | 2007-02-02 | Ldr Medical | Prothese de disque intervertebral |
FR2879436B1 (fr) | 2004-12-22 | 2007-03-09 | Ldr Medical | Prothese de disque intervertebral |
FR2891135B1 (fr) | 2005-09-23 | 2008-09-12 | Ldr Medical Sarl | Prothese de disque intervertebral |
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FR2893838B1 (fr) | 2005-11-30 | 2008-08-08 | Ldr Medical Soc Par Actions Si | Prothese de disque intervertebral et instrumentation d'insertion de la prothese entre les vertebres |
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2003
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- 2003-04-11 BR BRPI0318243-6A patent/BR0318243A/pt not_active IP Right Cessation
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- 2003-04-11 CN CNB038262878A patent/CN100544686C/zh not_active Expired - Fee Related
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- 2003-04-11 DE DE50308821T patent/DE50308821D1/de not_active Expired - Lifetime
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- 2003-04-11 AU AU2003213972A patent/AU2003213972B2/en not_active Ceased
- 2003-04-11 EP EP03709543A patent/EP1622549B1/de not_active Expired - Lifetime
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2007517628A (ja) * | 2004-01-15 | 2007-07-05 | ウォーソー・オーソペディック・インコーポレーテッド | ユニバーサル締り嵌めクリート |
Also Published As
Publication number | Publication date |
---|---|
KR20060011830A (ko) | 2006-02-03 |
NZ543434A (en) | 2007-04-27 |
WO2004089256A1 (de) | 2004-10-21 |
CA2529564A1 (en) | 2004-10-21 |
BR0318243A (pt) | 2006-04-04 |
ATE380532T1 (de) | 2007-12-15 |
ES2297132T3 (es) | 2008-05-01 |
AU2003213972B2 (en) | 2007-06-28 |
NZ543464A (ja) | 2007-04-27 |
EP1622549A1 (de) | 2006-02-08 |
JP4291779B2 (ja) | 2009-07-08 |
US20070073395A1 (en) | 2007-03-29 |
AU2003213972A1 (en) | 2004-11-01 |
DE50308821D1 (de) | 2008-01-24 |
US7628815B2 (en) | 2009-12-08 |
AU2003213972C1 (en) | 2004-11-01 |
EP1622549B1 (de) | 2007-12-12 |
CN100544686C (zh) | 2009-09-30 |
CN1764425A (zh) | 2006-04-26 |
KR100953145B1 (ko) | 2010-04-16 |
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