JP2007260361A - Tool for filling bone compensating material, and its filling method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To ensure security in a patient by dilating the bone defect part of the patient and filling the part with a bone compensating material. <P>SOLUTION: The dilating body 20 is put through a cylindrical body 18 in the filling tool 10. One end part of the cylindrical body 18 is inserted to the bone defect part 14 and also the part 14 is sealed by filling the bone compensating material 12 from the other end part 20b of the dilating body 20. When the dilating body 20 is pressurized from an outer part, the bone compensating material 12 is moved to the side of the bone defect part 14 through the cylindrical body 18. Then one end part 20a of the dilating body 20 is dilated inside the bone defect part 14. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a bone filling material filling device and a filling method for filling a bone filling material into a bone defect caused by a bone tumor or a vertebral body compression fracture caused by osteoporosis.

  In recent orthopedic osteoporosis treatments and fracture treatments, it is important to be minimally invasive in order to reduce the burden on patients. Percutaneous vertebroplasty (PVP) has been performed in response to vertebral fractures due to osteoporosis. As a filler to be filled into the vertebra by this percutaneous vertebroplasty, for example, calcium phosphate bone cement, polymethyl methacrylate (PMMA) bone cement or the like is used. However, since the filler is fed into the fracture site under pressure during the treatment, these fillers may leak out from the fracture site to the outside of the vertebral body, and there are concerns about side effects and biocompatibility.

  Thus, in recent years, vertebroplasty using a hydroxyapatite (HA) block has been developed and is becoming popular (see, for example, Patent Document 1). Since this hydroxyapatite block is solid, side effects and biocompatibility due to leakage from the fracture site to the outside can be avoided, and there is an advantage that it is not necessary to worry about curing time. On the other hand, the bone opening must be increased, the surgical wound becomes larger, the internal volume of the fracture site filled with the hydroxyapatite block is confirmed in advance, and the supply amount of the hydroxyapatite block is accurately determined. It needs to be managed and is complicated.

  Further, a method has been developed in which a balloon is inserted into a fractured vertebral body to be expanded, and a filling material is injected into the balloon at a low pressure to be filled (for example, see Patent Document 2).

International Patent No. 2005/055886 Pamphlet Japanese National Patent Publication No. 9-508292

  By the way, in the prior art which concerns on patent document 2, since a filler can be filled with the low pressure with respect to the inside of a fracture site | part, it is possible to suppress the leakage of the said filler material from this fracture site | part to the exterior. However, it cannot be completely prevented. In this method, it is necessary to take out the expansion member inserted into the fracture site before the filler is injected. Furthermore, polymethylmethacrylate (PMMA) bone cement used for the filler cannot be expected to promote bone formation at the fracture site, and calcium phosphate bone cement (CPC) requires a long time for bone formation at the fracture site. Cost.

  The present invention has been made in consideration of the above-described problems, and can expand a bone defect part such as a fracture part of a patient. An object of the present invention is to provide a bone filling material filling device and a filling method thereof that can avoid a state in which a desired effect cannot be expected due to a shortage, can be highly safe, and can reduce the burden on a patient and an operator. .

To achieve the above object, the present invention provides a filling device for filling a bone defect with a bone grafting material,
An expansion body that is formed to be expandable and into which the bone filling material is filled;
The expansion body is inserted inside, and a cylindrical body introduced into the bone defect,
With
One end portion of the expansion body is inserted into the bone defect portion, and the bone filling material supplied to the other end portion of the expansion body is filled into the bone defect portion through the expansion body in the cylinder. It is characterized by that.

  According to the present invention, the expansion body filled with the bone grafting material is inserted into the bone defect portion through the cylinder, and the bone filling material filled on the other end side of the expansion body is pressed. Thus, the bone replacement material is guided to the bone defect part side through the expansion body inserted into the cylindrical body, and the expansion body itself is moved to the bone defect part, and one end portion thereof is expanded to displace the bone repair material. The defect is filled.

  Therefore, by inserting the expansion body into the bone defect portion and filling the bone defect portion with the bone filling material via the expansion body, the bone defect portion is suitably spread out by the expansion body. Sufficient strength can be secured. Further, since the bone filling material is filled in the expansion body in the bone defect portion, it is possible to ensure sufficient safety for the patient without leaking to the bone defect portion side.

  Further, by exposing the other end of the expansion body from the cylinder, a bone filling material is filled between the other end of the expansion body and the cylinder, and the bone filling material is inserted into the bone defect side through the cylinder. Can be pushed out. That is, it becomes possible to provide in advance between the other end portion of the expansion body and the cylindrical body a filling portion capable of filling the expansion body with the bone grafting material.

  Furthermore, when the expansion body is formed from a film that is formed in a cylindrical shape and is folded so that the peripheral surface has an uneven shape, the expanded body is filled with the bone prosthetic material. The peripheral surface of the film folded into a wider area can be expanded to expand the inner volume. Thus, even when the expansion body is formed from the film, it can be suitably expanded along with the filling of the bone prosthetic material by folding the peripheral surface into an uneven shape.

  Furthermore, by forming the expansion body from an elastic material having elasticity, the expansion body can be suitably expanded by filling the expansion body with a bone grafting material, and the expansion body is utilized by utilizing the expansion / contraction force. Can be accommodated inside the bone defect. Therefore, it is preferable that the expansion body is not exposed to the bone defect portion after the filling of the bone defect portion is completed.

  In addition, the other end portion of the expansion body surrounds the outer periphery of the expansion body, and is provided with an extrusion member that can be displaced along the expansion body toward the bone defect portion side, thereby expanding the displacement member under the displacement action of the extrusion member. Since the body is squeezed inward, the bone filling material filled in the expansion body can be pressed and reliably and easily pushed out toward the bone defect portion side.

Furthermore, the present invention provides a bone filling material filling method for filling a bone defect material with a bone filling material using a filling device.
Inserting the cylindrical body of the filling device through which the expansion body has been inserted into the bone defect portion; and
Pressing the bone filling material through the expansion body in the tubular body toward the bone defect portion by pressing the expansion body filled with the bone filling material;
Expanding the expansion body inside the bone defect, and filling the bone defect with the bone filling material;
It is characterized by having.

  According to the present invention, the cylindrical body into which the expansion body is inserted is inserted into the bone defect portion, and the bone filling material filled in the expansion body is pressed to the bone defect portion side to be pushed out. By guiding the material to the bone defect through the expansion body inserted through the cylinder, the expansion body is expanded in the bone defect to be filled with the bone grafting material.

  Therefore, by pressing the expansion body, the expansion body itself is moved to the bone defect portion, and the bone prosthetic material is moved to the bone defect portion side through the cylindrical body, and the expansion body is expanded so that the bone defect portion is bone-filled. By filling the material, it is possible to expand the bone defect part with the expansion body to sufficiently secure the strength of the bone defect part, and the bone filling material filled in the bone defect part fills the expansion body. Therefore, there is no leakage from the expanded body to the bone defect side, and sufficient patient safety can be obtained. In addition, since the expansion body itself moves into the bone defect portion together with the bone grafting material, the expansion body can be adapted to the size of the bone defect portion even if the size of the bone defect portion is large. Even when the expansion body is formed of an elastic material having elasticity, it is preferable that the expansion body is not excessively stretched.

  Furthermore, before inserting the cylindrical body into the bone defect part, connecting an injection tool to the opening end of the expansion body and filling the bone filling material into the expansion body from the injection tool; and the opening And a step of sealing the end portion. Thereby, the bone defect is filled in the expansion body in a bag shape by pre-filling the inside of the expansion body with a bone filling material with an injection tool and sealing the opening end of the expansion body. it can. Therefore, the bone filling material does not leak out from the expansion body, and the bone filling material can be suitably filled through the bag-like expansion body.

  Furthermore, after the bone filling material is filled in the bone defect portion, the bone filling material is removed from the expansion body after filling the bone defect portion by sealing the end of the expansion body on the cylinder side. Since leakage to the outside is prevented, there is no leakage into the bone defect and sufficient safety for the patient is ensured.

  According to the present invention, the following effects can be obtained.

  That is, the bone filling material filled in the expansion body is pressed and guided to the bone defect part side through the expansion body serving as a cylinder, so that the expansion body is expanded in the bone defect part and filled with the bone filling material. is doing. As a result, the bone defect part is pushed and expanded through the expansion body to ensure sufficient strength of the bone defect part, and leakage of the bone filling material to the bone defect part side is prevented to ensure safety for the patient. Make it possible.

  A preferred embodiment of a bone filling material filling device and a filling method thereof according to the present invention will be described in detail below with reference to the accompanying drawings.

  In FIG. 1, reference numeral 10 indicates a filling device that is used in the method for filling a bone grafting material according to the first embodiment of the present invention and fills the bone defect with the bone grafting material.

  As shown in FIGS. 1 to 7, the filling device 10 is filled with a bone grafting material 12, an injection tool 16 capable of delivering the bone grafting material 12 to the bone defect portion 14, and the bone defect portion 14. A cylindrical body 18 inserted into the cylindrical body 18, and an expansion body 20 that is inserted into the cylindrical body 18 and is connected to the injection tool 16 and supplied with the bone prosthetic material 12 therein.

  The injection device 16 includes a cylindrical housing 22, a piston 24 that is displaceably provided in the housing 22, a chamber 26 that is provided between the housing 22 and the piston 24, and is filled with the bone prosthesis 12. And a lead-out port 28 communicating with the chamber 26 and opening to the outside. The injection device 16 is connected to the other end portion 20 b of the expansion body 20 opened through the outlet port 28.

  For example, polymethyl methacrylate (PMMA) bone cement, calcium phosphate bone cement (CPC), or the like can be used as the bone grafting material 12. By using these materials, the bone filling material 12 has fluidity and gradually hardens with the passage of a predetermined time. Further, the bone grafting material 12 may be a granule made of an inorganic material such as calcium phosphate ceramics, alumina ceramics, zirconia ceramics, or titanium.

  Then, when the surgeon 30 (see FIG. 3) presses the piston 24 and displaces it toward the outlet 28 side, the bone filling material 12 filled in the chamber 26 of the injection device 16 is pressed, and the bone The filling material 12 is sent into the expansion body 20 through the outlet 28.

  The cylindrical body 18 is formed in an elongated shape along the axial direction, and an insertion hole 32 (see FIG. 5) passes therethrough. The expansion body 20 is inserted into the insertion hole 32 and, for example, silicone oil is applied to the inner wall surface thereof. That is, the expansion body 20 is prevented from sticking when the expansion body 20 comes into close contact with the insertion hole 32 of the cylindrical body 18, so that the cylindrical body 18 and the expansion body 20 can be separated.

  The expansion body 20 is formed of a film 34 made of a resin material such as polyolefin, such as polyethylene or polypropylene, polyester, polyamide, etc., for example, and the film 34 has a cylindrical shape and a pleat shape along the circumferential direction. Folded to form. That is, the expansion body 20 is formed in a breez shape in which the peripheral surface is uneven in the radial direction. Furthermore, it is preferable that the expansion body 20 is formed from an extending | stretching material.

  It is more preferable that the film 34 constituting the expansion body 20 is formed in a thin film shape so as to fall within a range of 50 μm to 300 μm, for example, and the thickness is set to about 100 μm. The pressure strength of the film 34 is set to 300 psi, for example. As a result, the bone filling material 12 is filled in the expansion body 20 formed of the film 34, and even when pressure is applied to the expansion body 20, the expansion body 20 can be suitably expanded without being damaged.

  The expansion body 20 is formed to be long along the axial direction, and the longitudinal dimension of the expansion body 20 is set larger than the longitudinal dimension of the cylindrical body 18 (see FIG. 1). That is, when the expansion body 20 is inserted through the cylindrical body 18, the one end 20a side and the other end 20b side of the expansion body 20 are exposed to the outside.

  Furthermore, the sealing part 36 sealed by heat welding is formed in the one end part 20a of the expansion body 20 inserted in the bone defect part 14, for example. The sealing portion 36 is solidified by heating and welding the film 34. Thereby, in the one end part 20a of the expansion body 20, the communication between the inside and the outside of the expansion body 20 is blocked by the sealing portion 36, and the airtightness inside the expansion body 20 is maintained. The method of forming the sealing portion 36 is not limited to the case where the above-described thermal welding is performed. For example, the sealing portion 36 may be bonded with an epoxy-based adhesive, or a molten resin or a cured resin is attached. You may solidify by making it. That is, the one end 20a of the expansion body 20 having a cylindrical shape is securely sealed, the pressure resistance in the expansion body 20 is maintained, and the outside of the bone grafting material 12 supplied into the expansion body 20 Any method can be used as long as it can prevent leakage. On the other hand, the other end 20 b of the expansion body 20 is opened, and the injection tool 16 is connected through the outlet 28.

  Then, the bone grafting material 12 is led out from the injection device 16 to the other end 20b of the expansion body 20, and the bone grafting material 12 passes through the inside of the expansion body 20 from the other end 20b side to the one end 20a side. Moving. At this time, since the one end portion 20a of the expansion body 20 is reliably sealed by the sealing portion 36, the bone grafting material 12 does not leak to the outside.

  For example, silicone oil is applied to the inside of the expansion body 20, and the inner surfaces of the film 34 folded in a pleat shape with the silicone oil do not stick to each other. Therefore, the inner surfaces of the expansion body 20 can be folded and brought into close contact with each other in a peelable state.

  The filling device 10 used in the method for filling a bone prosthetic material according to the first embodiment of the present invention is basically configured as described above. Next, its operation and effects will be described. . Here, a case will be described in which the bone grafting material 12 is filled into the bone defect portion 14 caused by the vertebral body compression fracture in the vertebral body 42 which is the affected portion 40 of the osteoporotic patient 38.

  First, as an initial treatment, the anesthesia with respect to the patient 38 and the position of the vertebral body 42 of the affected part 40 are confirmed using an X-ray fluoroscopy device or the like, and the vertebra is used with a metal puncture needle 44 as shown in FIG. The insertion port 46 is opened percutaneously in the body 42. The bone defect portion 14 (fracture portion) inside the vertebral body 42 communicates with the insertion port 46. The puncture needle 44 may be prepared, for example, having three different diameters, and the diameter of the insertion port 46 may be gradually increased by using the puncture needle 44 in order from a small diameter. After the insertion port 46 is formed in this way and adjusted to match the outer diameter of the cylindrical body 18 in the filling device 10, the cylindrical body 18 is inserted into the insertion port 46 together with the puncture needle 44.

  Next, after removing the puncture needle 44 from the cylindrical body 18, the expanded body 20 folded in a pleat shape is inserted into the cylindrical body 18, and one end portion 20 a of the expanded body 20 is disposed on the distal side of the cylindrical body 18. The other end 20b is disposed so as to have a portion exposed to the proximal side from the cylindrical body 18 while being exposed in a certain bone. In addition, when inserting the expansion body 20 into the cylindrical body 18, a stylet (not shown) or the like that is formed in a long shaft shape may be used. Alternatively, the cylinder 18 in which the expansion body 20 is arranged in advance may be prepared, and the cylinder 18 may be inserted into another cylinder inserted into the vertebral body 42.

  Next, the injection tool 16 containing the bone grafting material 12 is attached to the other end 20b of the expansion body 20, and the surgeon 30 presses the piston 24 of the injection tool 16, whereby the outlet port 28 of the injection tool 16 is provided. The bone grafting material 12 is delivered from the inside of the expansion body 20 to fill the bone filling material 12 inside the expansion body 20. At this time, the bone grafting material 12 is filled between the other end 20b of the expansion body 20 and the cylindrical body 18, and expands in the radial direction while expanding the expansion body 20 folded in a pleat shape (see FIG. 3). ).

  Then, after the bone filling material 12 is filled in the expansion body 20, the injection tool 16 is removed from the other end portion 20 b of the expansion body 20, and the other end portion 20 b is crimped by the crimping tool 48. As a result, the other end 20b of the expansion body 20 that is opened is sealed by the caulking tool 48, and the bone filling material 12 is not leaked from the other end 20b of the expansion body 20 inside the expansion body 20. Preferably held. The caulking tool 48 may be, for example, a string made of a plastic or metal material, and is sealed by folding the other caulking tool 48 around the other end 20b of the expansion body 20. Is possible.

  As shown in FIG. 4, the X-ray apparatus 50 is operated to irradiate the affected area 40 with X-rays. The X-ray apparatus 50 includes an X-ray irradiation unit 52, a detection unit 54, a processing unit 56 that processes the X-rays detected by the detection unit 54 as an image, and a monitor 58 that displays the obtained image in real time. And have. Thereafter, the surgeon 30 can perform the procedure while viewing the image on the monitor 58.

  Next, the surgeon 30 presses the other end 20b of the expansion body 20 filled with the bone grafting material 12 toward the inner side (in the direction of arrow A), thereby bringing the bone grafting material 12 into the cylindrical body 18 side. While pushing out in the direction of arrow B, the other end 20b itself is displaced so as to push out toward the cylindrical body 18 side. As a result, the bone grafting material 12 flows toward the cylinder 18 inside the expansion body 20 and is guided to the inside of the cylinder 18 via the expansion body 20, and the other end of the expansion body 20. Similarly, the part 20b moves to the cylindrical body 18 side.

  And as FIG. 5 shows, while the expansion body 20 moves, the one end part 20a side of this expansion body 20 is inserted in the bone defect part 14 via the cylinder 18, and the inside of the expansion body 20 flows. The existing bone grafting material 12 reaches the one end portion 20a side of the expansion body 20, and starts filling the one end portion 20a side of the expansion body 20. Thereby, the one end part 20a side of the expansion body 20 is expanded by the filling of the bone grafting material 12 from the folded state, and gradually expands in the radial direction.

  As shown in FIG. 6, the bone grafting material 12 is filled into the bone defect portion 14 via the expansion body 20, and the filling of the bone grafting material 12 into the bone defect portion 14 is completed. Thereby, the bone defect | deletion part 14 is expanded under the filling action of the bone grafting material 12 via the expansion body 20, and can be returned to the state before a fracture. At this time, since the bone grafting material 12 is curable, it gradually hardens in the bone defect portion 14.

  Finally, as shown in FIG. 7, the cylindrical body 18 is detached from the insertion port 46 of the vertebral body 42 and extracted from the other end 20 b side of the expansion body 20. Then, the expansion body 20 exposed to the outside from the insertion port 46 is sealed again by crimping with a crimping tool 48 in the vicinity of the insertion port 46, and a part on the other end 20 b side from the crimping tool 48. Disconnect. Thereby, the crimping part of the expansion body 20 can be pushed into the vertebral body 42 through the insertion port 46 and accommodated, and the expansion body 20 is not exposed to the outside.

  As described above, in the first embodiment, the expanded body 20 filled with the bone grafting material 12 is provided inside the cylindrical body 18, and the bone grafting material 12 led out from the injection tool 16 to the expanded body 20. Can be filled into the bone defect 14 through the cylindrical body 18. Therefore, the strength of the bone defect portion 14 can be sufficiently ensured by hardening the bone grafting material 12 in the expanded body 20. As a result, the bone defect part 14 of the patient 38 can be expanded by the bone filling material 12 to ensure a sufficient strength, and the patient 38 can be promptly recovered.

  For example, even when polymethyl methacrylate (PMMA) bone cement, calcium phosphate bone cement (CPC) or the like is used as the bone grafting material 12, the bone grafting material 12 is covered with the expansion body 20 in the bone defect portion 14. Therefore, it does not leak to the bone defect part 14 side which is the outside of the expansion body 20. Thereby, the safety | security at the time of using the bone grafting material 12 with respect to the bone defect part 14 is ensured.

  Furthermore, since the expansion body 20 filled with the bone grafting material 12 can be expanded and deformed, the shape of the expansion body 20 can be freely deformed according to the shape of the bone defect portion 14 to sufficiently secure the bone grafting material 12. Can be filled.

  Furthermore, when the fluid bone substitute material 12 is used for the bone defect portion 14, the fluid bone substitute material 12 is exchanged via the expansion body 20 as compared with the case where the solid bone substitute material 12 is filled. Since the bone defect part 14 can be filled more densely, the strength of the bone defect part 14 can be further increased.

  Next, FIG. 8 to FIG. 11 show a bone filling material filling device 100 according to a second embodiment. In addition, the same referential mark is attached | subjected to the component same as the filling instrument 10 which concerns on 1st Embodiment mentioned above, and the detailed description is abbreviate | omitted.

  The filling device 100 according to the second embodiment is different from the filling device 10 according to the first embodiment in that the expansion body 102 is formed in a bag shape from a stretchable elastic material. .

  The expansion body 102 is formed of an elastic material such as silicone rubber, styrene elastomer, olefin elastomer, and the like. Specifically, as styrene-based elastomers, Kraton (Shell Chemical), Califlex (Shell Chemical), Tufprene (Asahi Kasei Kogyo), Tuftec (Asahi Kasei Kogyo), Aron AR (Aron Kasei), Lavalon (Mitsubishi Chemical), JSR- TR (Japanese synthetic rubber), JSR-SIS (Japanese synthetic rubber), Dynalon (Japanese synthetic rubber), Septon (Kuraray), etc. are mentioned. Examples of the olefin elastomer include Miralastomer (Mitsui Petrochemical), Tuffmer (Mitsui Petrochemical), Sumitomo TPE (Sumitomo Chemical), and Thermoran (Mitsubishi Petroleum). You may add and use additives, such as a plasticizer, for these materials as needed.

  Moreover, the thickness of the expansion body 102 is good to set in the range of 50 micrometers-300 micrometers.

  Next, a case where the bone grafting material 12 is filled into the bone defect portion 14 using the filling device 100 will be described.

  First, as shown in FIG. 8, the injection tool 16 is connected to the opening end portion 102 a of the expansion body 102 having a bag shape, and the bone grafting material 12 is delivered into the expansion body 102. The expansion body 102 expands between the injection tool 16 and the cylindrical body 18 by filling the bone grafting material 12. The expansion body 102 is inserted into the cylindrical body 18 in advance, and is inserted into the bone defect portion 14 together with the end of the cylindrical body 18. In addition, after the bone filling material 12 is filled in the expansion body 102, the injection tool 16 is removed from the opening end portion 102a and crimped with a crimping tool 48 (see FIG. 9). Thereby, the sealing part 104 by which the opening end part 102a of the expansion body 102 was sealed is formed, and the leakage of the bone grafting material 12 from the sealing part 104 is prevented (see FIG. 9).

  Next, the surgeon 30 presses the expanded portion of the expansion body 102 filled with the bone grafting material 12 toward the cylindrical body 18 (in the direction of arrow B), so that the bone grafting material 12 is It flows toward the cylindrical body 18 inside and moves into the bone defect 14 through the expansion body 102 in the cylindrical body 18.

  Then, as shown in FIG. 9, the expansion body 102 begins to expand with the bone grafting material 12 in the bone defect portion 14, and the inside of the bone defect portion 14 is filled with the bone grafting material 12 through the expansion body 102. Thus, the filling of the bone defect 14 is completed. Thereby, the bone defect | deletion part 14 is expanded under the filling effect | action of the bone grafting material 12 via the expansion body 102, and can be returned to the state before a fracture. At this time, since the bone grafting material 12 is curable, it gradually hardens in the bone defect portion 14.

  In this case, since the expansion body 102 is formed of an elastic material having elasticity, the expansion body 102 inserted into the bone defect portion 14 expands under the action of filling the bone prosthesis material 12, thereby the expansion body 102. The sealing portion 104 of 102 is pulled toward the bone defect portion 14 side. Therefore, for example, when the operator 30 twists the sealing portion 104 of the expansion body 102 several times and then cuts the expansion body 102 through the inside of the cylindrical body 18 by the stretching force, the insertion port 46 side of the vertebral body 42 And is accommodated in the insertion port 46 (see the broken line shape in FIG. 10).

  Finally, as shown in FIG. 11, the cylindrical body 18 is detached from the insertion port 46 of the vertebral body 42, whereby the end 102 b of the expansion body 102 is accommodated in the vertebral body 42 through the insertion port 46. Become. Thereby, the expansion body 102 is suitably accommodated in the insertion port 46 and is not exposed to the outside. Since the end 102b of the expansion body 102 is twisted and sealed several times, the bone filling material 12 inside the expansion body 102 does not leak to the outside, but the end 102b is caulked. If it is made to crimp with the tool 48 (not shown), it will become possible to seal more reliably.

  Next, a bone filling material filling instrument 150 according to a third embodiment is shown in FIGS. In addition, the same referential mark is attached | subjected to the component same as the filling instruments 10 and 100 which concern on 1st and 2nd embodiment mentioned above, and the detailed description is abbreviate | omitted.

  In the filling instrument 150 according to the third embodiment, a guide pin 154 is provided inside the expansion body 152, and the bone filling material 12 filled inside the expansion body 152 is directed toward the bone defect portion 14 side. This is different from the filling devices 10 and 100 according to the first and second embodiments in that an extrusion tool (extrusion member) 156 for extruding is provided.

  The filling device 150 includes an expansion body 152 formed in a thin film bag shape, a linear guide pin 154 provided inside the expansion body 152, and a cylindrical body 158 through which the guide pin 154 and the expansion body 152 are inserted. The expansion body 152 is pulled and deformed by the guide pin 154 along the axial direction of the guide pin 154. That is, both the guide pin 154 and the expansion body 152 are in a state of extending so as to be elongated along the axial direction.

  One end portion 152a of the expansion body 152 is inserted into the bone defect portion 14 through the insertion port 46 together with the guide pin 154, and the other end portion 152b of the expansion body 152 is filled with the bone filling material 12 inside the expansion body 152. After that, it is crimped by the crimping tool 48. Thereby, the expansion body 152 is sealed and the leakage of the bone grafting material 12 is prevented. In addition, the other end portion 152 b of the expansion body 152 is provided with a pusher 156 in the vicinity of the caulking tool 48 so as to be displaceable. The pusher 156 is connected to the caulking tool 48 at one end portion of the expansion body 152. It is arranged on the 152a side.

  Since the pusher 156 is formed in a cylindrical shape, and the expansion body 152 is inserted through the pusher 156, when the pusher 156 is displaced along the axial direction of the guide pin 154, the expansion body 152 becomes the pusher. By 156, it is forcibly squeezed toward the guide pin 154 side.

  Further, the expansion body 152 is detachably provided with a restriction tool 160 for restricting the movement of the bone grafting material 12 at a position on the cylindrical body 158 side, and the bone filling material 12 is expanded by removing the regulation tool 160. The body 152 can move from the other end 152b side to the one end 152a side. The restricting tool 160 is made of, for example, a clip that can hold the expansion body 152 from the outside.

  When filling the bone grafting material 12 into the bone defect portion 14 using the filling device 150, first, the restricting tool 160 is removed from the state shown in FIG. 12 and along the expansion body 152 and the guide pin 154. Thus, the pusher 156 is displaced toward the one end 152a of the expansion body 152. As a result, since the expansion body 152 is squeezed toward the guide pin 154, the bone filling material 12 filled in the expansion body 152 is subjected to the displacement action of the pusher 156 as shown in FIG. It is gradually pressed toward the cylindrical body 158 and is guided to the bone defect 14 side through the space between the expansion body 152 and the guide pin 154. At this time, the bone filling material 12 can be reliably and easily pushed out toward the bone defect portion 14 by the pusher 156.

  Then, the inside of the bone defect 14 is gradually filled with the bone grafting material 12 through the expansion body 152, and the filling of the bone defect 14 is completed. Thereby, the bone defect | deletion part 14 is expanded under the filling effect | action of the bone grafting material 12 via the expansion body 152, and it can return to the state before a fracture.

  Finally, the pusher 156 is again displaced along the guide pin 154 toward the other end 152b of the expansion body 152, and the guide pin 154 is taken out from the expansion body 152 to the outside. Then, the restrictor 160 is attached to the expansion body 152 again in the vicinity of the insertion port 46 to prevent leakage of the bone grafting material 12 from the expansion body 152, and then the other end 152b side of the expansion body 152 is cut. And seal.

  Moreover, the application target of the percutaneous vertebroplasty using the filling devices 10, 100, and 150 described above is not limited to the vertebral body 42, and can be applied to other bone defect portions 14.

  Of course, the bone filling material filling method and filling device according to the present invention are not limited to the above-described embodiments, and various configurations can be adopted without departing from the gist of the present invention.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a partially omitted overall configuration diagram showing a bone filling material filling device according to a first embodiment of the present invention. It is sectional drawing which shows the state which opened the insertion port with the puncture needle with respect to the patient's vertebral body. It is sectional drawing which shows the state which inserted a part of cylinder into the bone defect part from the insertion port of FIG. It is a schematic diagram which shows a mode that percutaneous vertebroplasty is performed using an X-ray apparatus and a filling instrument. It is sectional drawing which shows the state which started the filling by pressing the other end part of the expansion body of FIG. 4, and pushing out the bone grafting material to the bone defect part side. It is sectional drawing which shows the state with which the bone defect part of FIG. 5 was satisfy | filled with the bone filling material with which it filled. It is sectional drawing which shows the state which cut | disconnected the edge part of the expansion body of FIG. 6, sealed by crimping, and accommodated the crimping part in the insertion port. It is a whole block diagram which shows the filling instrument of the bone grafting material which concerns on the 2nd Embodiment of this invention. It is sectional drawing which shows the state with which the filling instrument of FIG. 8 was inserted in the bone defect part through the insertion opening, and was filled with the bone filling material with which the said bone defect part was filled. It is sectional drawing which shows the state which sealed the edge part of the expansion body of FIG. 9, and moved the said edge part into the cylinder body under the expansion-contraction action of the said expansion body. It is sectional drawing which shows the state which removed the cylinder from the bone defect part of FIG. 10, and the edge part of the expansion body was accommodated in the insertion port of a vertebral body. It is a whole block diagram which shows the filling instrument of the bone grafting material which concerns on the 3rd Embodiment of this invention. FIG. 13 is a cross-sectional view showing a state in which the filling device of FIG. 12 is inserted into a bone defect portion through an insertion port and a bone prosthetic material is started to be filled in the bone defect portion.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10, 100, 150 ... Filling instrument 12 ... Bone prosthesis material 14 ... Bone defect part 16 ... Injection tool 18, 158 ... Cylindrical body 20, 102, 152 ... Expansion body 30 ... Operator 36, 104 ... Sealing part 38 ... Patient 42 ... Vertebral body 46 ... Insertion port 48 ... Clamping tool 50 ... X-ray apparatus 154 ... Guide pin 156 ... Pushing tool 160 ... Restriction tool

Claims (8)

In a filling device for filling a bone defect with a bone filling material,
An expansion body that is formed to be expandable and into which the bone filling material is filled;
The expansion body is inserted inside, and a cylindrical body introduced into the bone defect,
With
One end portion of the expansion body is inserted into the bone defect portion, and the bone filling material supplied to the other end portion of the expansion body is filled into the bone defect portion through the expansion body in the cylinder. A bone filling material filling device. The filling device according to claim 1, wherein
The bone filling material filling device, wherein the other end of the expansion body is exposed from the cylindrical body. The filling device according to claim 1 or 2,
The bone filling material filling device, wherein the expansion body is formed into a bag shape from a film that is formed in a cylindrical shape and is folded so that the peripheral surface is uneven. The filling device according to claim 1 or 2,
The expansion body is formed into a bag shape from an elastic material having elasticity, and is a filling device for a bone grafting material. The filling device according to any one of claims 1 to 4,
The bone filling material filling device, characterized in that an extruding member is provided at the other end of the expansion body so as to surround the outer periphery of the expansion body and to be displaced along the expansion body toward the bone defect portion side. . In the method of filling the bone prosthetic material by filling the bone defect with the bone prosthetic material using the filling device,
Inserting the cylindrical body of the filling device through which the expansion body has been inserted into the bone defect portion; and
Pressing the bone filling material through the expansion body in the tubular body toward the bone defect portion by pressing the expansion body filled with the bone filling material;
Expanding the expansion body inside the bone defect, and filling the bone defect with the bone filling material;
A method for filling a bone grafting material, comprising: The filling method according to claim 6.
Before inserting the cylindrical body into the bone defect, connecting an injection tool to the open end of the expansion body, and filling the bone filling material into the expansion body from the injection tool;
Sealing the open end;
A method for filling a bone grafting material, comprising: The filling method according to claim 6 or 7,
A method for filling a bone grafting material, comprising the step of sealing an end of an expansion body on the cylindrical body side after the bone grafting material is filled in the bone defect portion.

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