JP2006524513A - 椎間インプラント - Google Patents
椎間インプラント Download PDFInfo
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- JP2006524513A JP2006524513A JP2004571213A JP2004571213A JP2006524513A JP 2006524513 A JP2006524513 A JP 2006524513A JP 2004571213 A JP2004571213 A JP 2004571213A JP 2004571213 A JP2004571213 A JP 2004571213A JP 2006524513 A JP2006524513 A JP 2006524513A
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- implant
- ring
- intervertebral
- rotation
- intervertebral implant
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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
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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
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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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- 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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- A61F2002/30001—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
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- A61F2002/30364—Rotation about the common longitudinal axis
- A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
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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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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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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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- 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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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
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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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- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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Abstract
Description
欧州特許第EP−A 1 219266号(特許文献2)により、半径方向から傘歯車ピニオンを介してねじれうる傘歯車歯を有するネジリングを有する伸縮式の椎間プロテーゼが周知である。この周知の装置における不利点は、ネジリングがスリーブ部の1つと軸方向にしっかりと接続されていることである。それによって、インプラントは不安定に構成され、さらにインプラントの伸延をめぐる特殊な器具の必要を招く。この周知のインプラントの別の不利点は、「許容可能」ではなく、したがって不利である使用される傘歯車歯にある。傘歯車歯の場合には、駆動器具が小さな軸方向の移動に際してももはやその機能を発揮できず、外科医は現場で器具を新たに配置しなければならない。
本発明の別の有利な展開は、従属請求の範囲で特徴付けられている。
本発明によって達成される利点は、本発明による椎間インプラントのおかげで簡単な取扱いが可能であり、これが一方では安全性を高め、かつ他方では移植に費やされる時間を削減する。
特別な実施形態においては、椎間インプラントのリングは下部インプラント部におけるクリップ接続によって軸方向にしっかりと、しかし回転可動に固定されている。こうして、リングは駆動のために確実に適所にとどまり、すなわち、リングは軸方向に偏位しえない。
好ましくは、クリップ接続は、リングにおけるトーラス状のアンダーカットと、下部インプラント部のジャケットの自由端におけるそれと対応するリング状の膨出部とから形成される。それによってリングの回転が、両方のスリーブ状のインプラント部と同じ中心で回転が生じるように保証される。
別の実施形態においては、リングは、下部インプラント部に向いた下部環面と、上部インプラント部に向いた上部環面とを有し、ここで下部環面は、それと対応するピニオンを受入れるのに適している歯付リムを有する。この実施は、ピニオンを支持する器具の半径方向の回転によってリングの軸方向の回転を可能にする。リングが接線方向に移動されなければならない周知のインプラントに対して、ねじり器具のさらにリングの新しい穴へ導入しなければならない必要なしに無限のねじりが可能であるため、ねじり器具用の所要スペースがより小さく、かつ速度がより高いという利点が生じる。
別の実施形態においては、下部インプラント部のジャケットは、歯付リムに対するピニオンを位置付けし、かつこれを支持するのに適している、半径方向の、好ましくは貫通している凹みを有する。それによって、脊椎の伸延完了後に、貫通している凹みによって骨粉を下部インプラント部のキャビティヘ導入することができる有利な可能性が生じる。
別の実施形態においては、上部インプラント部の円筒形シャフト(6)は―下部インプラント部に対する上部インプラント部の回転を防ぐために―回転軸に対して平行に走るガイドスリットと、下部インプラント部のジャケットはその内面において、内側へ突出し、ガイドスリットに係合するガイド要素(17)とを有し、これは好ましくは半径方向の穴によってジャケットに挿入可能である。それによって、両方のインプラント部の相互の回転が回避される。相互の回転はインプラントの終板との接触および脊椎前弯角度を損なうことになる。
別の実施形態においては、円筒形シャフトの雄ネジおよびリングの雌ネジは自己ロック式に形成されている。ネジの自己ロックによって、インプラントは任意の高さへ伸延されうるが、そのための追加の調節は不要である。
別の実施形態においては、雄ネジおよび雌ネジのピッチは0.5ないし1.0mm、好ましくは0.6−0.8mmの範囲である。例えば、2mmの範囲のより大きなピッチは、伸延は粗野であることが判明したため術中の不利点を示し、より小さなピッチは結果として時間的に長いねじれを伴った。
別の実施形態においては、雄ネジおよび雌ネジは右ネジとして形成されている。それにより、ピニオンを有する器具は、いつものやり方で、インプラントを伸延させるために、通常のネジ回しのように右に回転されうる利点が生じる。
別の実施形態においては、雄ネジおよび雌ネジは多条、好ましくは2条のネジとして形成されている。2条のネジの場合、リングの回転1回につき2倍の行程が達成される。それによって、インプラントのより迅速かつ簡単な操作が生じ、これが手術時間を短縮させ、かつ患者にとってやさしくなる。
別の実施形態においては、両方の付加部は、隣接する脊椎のカバープレートへ配置するために規定された付加面を有する、回転軸に対して横切って立つプレート状の要素として形成されている。
別の実施形態においては、付加面は回転軸に対して直交ではなく、好ましくは回転軸と83°ないし85°の角度を形成して配置されている。それによって、解剖学的関係に対する良好な適合が生じる。好ましくは、両方の付加面は互いに10°ないし14°の角度を含む。それによって、解剖学的な脊椎前弯角度を確保することに成功する。
別の実施形態においては、両方の付加面の少なくとも1つ、好ましくは上部インプラント部の付加面が外側に曲がっている。それによって、椎体への最適な適合が生じる。下部インプラント部の付加面は、好ましくは実質的に平坦に形成されている。
別の実施形態においては、歯付リムはまっすぐに歯が付けられている。円錐/らせん状の歯付リムに対して平歯は「許容可能」である。
本発明および本発明の展開を以下、多くの実施例の部分的概略図を用いて詳細に述べる。
図1は、組立てられた状態の椎間インプラントを示す斜視図である。
図2は、分解された状態の椎間インプラントを示す斜視図である。
図3は、図1による椎間インプラントの回転軸を通じて示される縦断面図である。
図4は、図1による椎間インプラントを示す正面図である。
図5は、分解された状態の図1による椎間インプラントの回転軸を通じて示される縦断面図である。
図6は、分解された状態の図1による椎間インプラントを示す正面図である。
リング9は、上部インプラント部5の雄ネジ7と協働する雌ネジ10を有し、ここで両方のインプラント部2、5およびリング9はその共通の回転軸11に沿って同軸に配置されており、シャフト6の雄ネジ7上のリング9のねじれによって両方の付加部4、8間の距離は無限に可変である。リング9はクリップ接続によって、下部インプラント部2と軸方向にしっかりと、しかし回転可動に接続されている。
図3に示されているように、クリップ接続は、リング9におけるトーラス状のアンダーカット21と、下部インプラント部2のジャケット14の自由端におけるそれと対応するリング状の膨出部22とから成る。
リング9は、下部インプラント部2に向いた下部環面12と、上部インプラント部に向いた上部環面13とを有し、ここで下部環面12は、それと対応するピニオンを受入れるのに適している歯付リム23を有する。
下部インプラント部2に対する上部インプラント部5の回転を防ぐために、上部インプラント部5の円筒形シャフト6は回転軸11に対して平行に走るガイドスリット16を、下部インプラント2のジャケット14はその内面において、内側へ突出し、ガイドスリット16に係合するガイド要素17(図2)とを有し、これは半径方向の穴18によってジャケット14に挿入可能である。
円筒形シャフト6の雄ネジ7およびリング9の雌ネジ10は自己ロック式に形成されている。雄ネジ7および雌ネジ10のピッチは0.7mmである。雄ネジ7および雌ネジ10は2条の右ネジとして形成されている。
図3に示されているように、両方の付加部4、8は、回転軸11に対して斜めに立つプレート状の要素として隣接する脊椎のカバープレートへ配置するために規定された付加面19、20とともに形成されており、ここで付加面19、20は回転軸11に対して直交には配置されておらず、回転軸11と85°の角度を含む。したがって、両方の付加面19、20は互いに10°の角度を含む。上部付加面20は―図3に示されているように―外側に曲がっているが、その一方で下部インプラント部の付加面19は実質的に平坦に形成されている。
椎間インプラントは、通常のインプラント材料から製造されうる。好ましくは、融合の判断をX線によって可能にするために、X線透過性PEEKが使用される。
椎間インプラントは、脊柱の頸部およびより高い胸郭範囲における椎体代替物として特に適している。
4 付加部 5 上部インプラント部 6 シャフト 7 雄ネジ
8 付加部 9 リング 10 雌ネジ 11 回転軸
12 下部環面 13 上部環面 14 ジャケット 15 凹み
16 ガイドスリット 17 ガイド要素 18 小穴 19 付加面
20 付加面 21 アンダーカット 22 膨出部 23 歯付リム
Claims (17)
- 椎間インプラント(1)であって、
A)ジャケット(14)と、回転軸(11)と、隣接した下部脊椎のカバープレートへ配置するために規定された付加部(4)を備えた中空円筒形キャビティ(3)とを有する下部インプラント部(2)と、
B)雄ネジ(7)と、前記下部インプラント(2)のキャビティ(3)へ延びる回転軸(11)と、隣接する上部脊椎のカバープレートへの配置のために規定された付加部(8)とを備えた実質的に円筒形のシャフト(6)を有する上部インプラント部(5)と、ここで、
C)前記両方のインプラント部(2、5)がその回転軸(11)の周りの回転に対して保護されており、ならびに、
D)前記上部インプラント部(5)の雄ネジ(7)と協働する雌ネジ(10)を有する前記両方のインプラント部(2、5)間に配置されたリング(9)とを有し、ここで、
E)前記両方のインプラント部(2、5)および前記リング(9)がその共通の回転軸(11)に沿って同軸に配置されており、
F)前記シャフト(6)の前記雄ネジ(7)上の前記リング(9)のねじれによって、前記両方の付加部(4、8)間の距離が連続的に可変である椎間インプラント(1)において、
G)前記リング(9)が軸方向にしっかりと、しかし回転可動に前記インプラント部(2)と接続されており、かつ
H)前記リング(9)が、前記下部インプラント部(2)に向いた下部環面(12)と、前記上部インプラント部に向いた上部環面(13)とを有し、
I)前記下部環面(12)が、それと対応するピニオンを受入れるのに適している歯付リム(23)を有することを特徴とする椎間インプラント。 - 前記リング(9)が、下部インプラント部(2)におけるクリップ接続によって軸方向にしっかりと、しかし回転可動に固定されてい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(1)。
- 前記クリップ接続が、前記リング(9)におけるトーラス状のアンダーカット(21)と前記下部インプラント部(2)の前記ジャケット(14)の自由端におけるそれと対応するリング状の膨出部(22)とから形成され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(1)。
- 前記下部インプラント部(2)の前記ジャケット(14)が、歯付リム(23)対してピニオンを位置付け、かつ支持するのに適している半径方向の凹み(15)を有することを特徴とする請求項1ないし3のいずれか1項に記載の椎間インプラント(1)。
- 前記凹み(15)が貫通していることを特徴とする請求項4に記載の椎間インプラント(1)。
- 前記下部インプラント部(2)に対する前記上部インプラント部(5)の回転(6)を防止するために、上部インプラント部(5)の前記円筒形シャフト(6)が前記回転軸(11)に対して平行に走るガイドスリット(16)を有し、その内面における前記下部インプラント部(2)が、中へ突出する、前記ガイドライン(16)に係合するガイド要素(17)を有し、これが好ましくは半径方向の小穴(18)を通じて前記ジャケット(14)に挿入可能であることを特徴とする請求項1ないし5のいずれか1項に記載の椎間インプラント(1)。
- 前記上部インプラント部(5)の前記円筒形シャフト(6)が、前記下部インプラント部(2)の前記中空円筒形キャビティ(3)よりも小さな大きさを有し、前記両方の構成要素が接触しないことを特徴とする請求項1ないし6のいずれか1項に記載の椎間インプラント(1)。
- 前記円筒形シャフト(6)の前記雄ネジ(7)および前記リング(9)の前記雌ネジ(10)が自己ロック式に形成されていることを特徴とする請求項1ないし7のいずれか1項に記載の椎間インプラント(1)。
- 前記雄ネジ(7)および前記雌ネジ(10)のピッチが0.5ないし1.0mm、好ましくは0.6−0.8mmの範囲にあることを特徴とする請求項8に記載の椎間インプラント(1)。
- 前記雄ネジ(7)および前記雌ネジ(10)が右ネジとして形成されていることを特徴とする請求項1ないし9のいずれか1項に記載の椎間インプラント(1)。
- 前記雄ネジ(7)および前記雌ネジ(10)が多条ネジとして、好ましくは2条ネジとして形成されていることを特徴とする請求項1ないし10のいずれか1項に記載の椎間インプラント(1)。
- 前記両方の付加部(4、8)が前記回転軸(11)に対して横切って立つプレート状の要素として前記隣接する脊椎の前記カバープレートへ配置するために規定された付加面(19、20)とともに形成されていることを特徴とする請求項10ないし11のいずれか1項に記載の椎間インプラント(1)。
- 前記付加面(19、20)が前記回転軸(11)に対して非直交に配置されており、かつ好ましくは前記回転軸(11)と83°ないし85°の角度を含むことを特徴とする請求項12に記載の椎間インプラント(1)。
- 前記両方の付加面(19、20)が相互に10°ないし14°の角度を含むことを特徴とする請求項13に記載の椎間インプラント(1)
- 前記両方の付加面(19、20)の少なくとも1つ、好ましくは前記上部インプラント部(5)の付加面が外側に曲がっていることを特徴とする請求項12ないし14のいずれか1項に記載の椎間インプラント(1)
- 前記下部インプラント部の前記付加面(19)が実質的に平坦に形成されてい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(1)。
- 前記歯付リム(23)がまっすぐに歯が付けられていることを特徴とする請求項4ないし15のいずれか1項に記載の椎間インプラント(1)。
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- 2003-04-28 BR BRPI0318221-5A patent/BR0318221B1/pt not_active IP Right Cessation
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JP2010521242A (ja) * | 2007-03-13 | 2010-06-24 | ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング | 調整可能な椎間インプラント |
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US7641693B2 (en) | 2010-01-05 |
KR101129769B1 (ko) | 2012-03-23 |
BR0318221B1 (pt) | 2013-01-22 |
EP1620044B1 (de) | 2008-03-19 |
US20060100710A1 (en) | 2006-05-11 |
CA2524066A1 (en) | 2004-11-11 |
WO2004096103A1 (de) | 2004-11-11 |
ES2300566T3 (es) | 2008-06-16 |
EP1620044A1 (de) | 2006-02-01 |
CN100581506C (zh) | 2010-01-20 |
NZ543180A (en) | 2009-10-30 |
BR0318221A (pt) | 2006-04-04 |
JP4245566B2 (ja) | 2009-03-25 |
TWI333416B (en) | 2010-11-21 |
TW200422035A (en) | 2004-11-01 |
AR044093A1 (es) | 2005-08-24 |
ATE389374T1 (de) | 2008-04-15 |
CN1774219A (zh) | 2006-05-17 |
CA2524066C (en) | 2011-03-15 |
KR20060004965A (ko) | 2006-01-16 |
AU2003218855A1 (en) | 2004-11-23 |
DE50309438D1 (de) | 2008-04-30 |
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