JP2009136440A - Fixation tool of adjacent spines of cervical vertebra - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a tool to fix the adjacent spines of the cervical vertebra by a smaller skin incision aiming at a low-invasive therapeutic method. <P>SOLUTION: The fixation tool comprises a rod 2 having a connection shaft, a pendulum 3 supported by the end of the connection shaft, a cover 4 provided with a guide hole and a movable groove for use of the connection shaft, and a stopper 5 fixable to the connection shaft. The pendulum has curved parts (3a, 3b) formed at both sides of the position where it is supported. When the pendulum got through between the adjacent spines, it rotates to enable the curved parts to come into contact with both of the adjacent spines. The cover has the curved parts (4a, 4b) for contacting the adjacent spines formed at both sides of the guide hole for the shaft. The cover can go through the connection shaft using its own guide hole for the shaft and can be adjusted its posture using its own movable groove so that the cover's longitudinal direction can near the shaft's axial direction. The state of the adjacent spines being put between the curved parts of both pendulum and cover is fixed and maintained. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a medical device capable of fixing adjacent spinous processes of a cervical spine percutaneously or minimally invasively.

When the cervical vertebra is dislocated due to trauma, etc., intervertebral instability occurs, intervertebral instability occurs due to changes associated with dialysis or aging, or the intervertebral instability occurs due to disease, etc. It is relatively often necessary to fix between adjacent cervical spinous processes. For example, the cervical intervertebral disc degenerates and becomes unstable, and upper limb nerve root paralysis such as upper limb / muscular weakness and numbness appears. In such a case, pain in the cervix continues when the cervical spine is unstable, and if it is poorly arranged, it may shift to chronic pain. . After surgery, reoperation may be necessary in the future due to instability between adjacent vertebrae.
In addition, in cervical spondylotic myelopathy, there is a state in which a so-called dynamic factor is applied (a state in which the spinal cord is dynamically compressed), and for this, direct fixation between the target spinous processes is directly treated. It is thought that it leads to.

  The conventional method of fixing the spinous process of the cervical spine is to expand the spinous process greatly under general anesthesia and fasten the adjacent spinous process to be fixed with a wire, or pinch it with a metal plate from the left and right and fix it. Met. Patients may be exposed to risk of bleeding and serious complications due to large spinous processes under general anesthesia, and require hospitalization in the ward for days to weeks after surgery It becomes. Therefore, this method places a heavy burden on the patient, and may worsen the symptoms particularly when the patient is elderly.

  Treatments that can fix spinous processes from smaller skin incisions in recent years, with a shorter recovery period, little bleeding, reduced risk of serious complications, and lower treatment costs for the patient, In some cases, implant devices that enable treatment that can be performed under local anesthesia are used in the medical field (see, for example, Patent Document 1 and Non-Patent Document 1).

  As an implant device for fixing adjacent spinous processes of the cervical vertebra used in a medical field, for example, the one shown in FIG. As shown in FIG. 11, the spinous process fixture of Non-Patent Document 1 includes a hook member (FIG. 11 (1)) and a rod member (FIG. 11 (2)). As shown in FIGS. 12 (1) to (7), one procedure for fixing the spinous process using the spinous process fixture of Non-Patent Document 1 is to connect a hook member and a rod member to adjacent spinous processes. Assembling around. First, as shown in FIG. 12 (1), a guide hole is created in the interspinous ligament with a starter owl, and then, as shown in FIG. 12 (2), hook members are used at two locations on the caudal side using a hook holder. Next, the rod size is determined as shown in FIG. 12 (3), and a hook member is attached in advance to the central portion of the rod member. Then, as shown in FIG. 12 (4), the hook member and the rod member previously mounted are connected and temporarily fixed, and compression is applied from the head-tail side as shown in FIG. 12 (5). As shown in 6), the spinous process is compressed and finally fixed (FIG. 12 (7)).

Since the spinous process fixture of Non-Patent Document 1 involves the procedure as described above, a plurality of small hook members are handled at the same time, and the operation of adjusting the plurality of hook members is necessary to adjust the compression. In addition, the skin incision for securing the operative field was inevitable to be expanded to the peripheral part of the adjacent spinous process.
Thus, although the method of fixing the adjacent spinous process of the cervical spine using the spinous process fixture of Non-Patent Document 1 is a treatment that can fix the spinous process from a smaller skin incision than the conventional method, As such, there are a burden on the patient due to the size of the skin incision and an operator burden due to the complexity of handling the instrument.

JP 2002-95672 A TADPOLE Tadpole System France Kisco Media Catalog (Kisco medicl group Catalog No. 04.12 / 01-007J-CA)

  An object of the present invention is to provide a device capable of fixing adjacent spinous processes in the cervical vertebra or lumbar vertebra by a smaller skin incision for the purpose of realizing a less invasive treatment method for cervical spondylotic myelopathy or the like. Objective.

The present inventor is a doctor who specializes in organ therapy, and has proposed the spinous process fixture according to the present invention after many clinical experiences for spinal canal stenosis, cervical spondylotic myelopathy, and the like.
In order to achieve the above object, a spinous process fixture of the present invention includes a rod member provided with a connecting shaft, a pendulum member that can abut on an adjacent spinous process that is pivotally supported at the tip of the connecting shaft, and a connecting shaft. A covering member capable of coming into contact with an adjacent spinous process provided with a guide hole and a movable groove for a connecting shaft, and a stopper member that can be fixed to the connecting shaft;
1) The pendulum member is formed with a curved portion at a portion facing the shaft support position, and the bent portion rotates when the tip end portion of the connecting shaft and the pendulum member pass between adjacent spinous processes. The curved portion can move against the adjacent spinous process,
2) The covering member is formed with a curved portion capable of coming into contact with the adjacent spinous process at a portion facing the connecting shaft guide hole, passed from the connecting shaft guide hole to the connecting shaft, and covered by the connecting shaft movable groove. The posture can be adjusted so that the longitudinal direction of the member faces the axial direction of the connecting shaft,
3) The stopper member can be fitted or abutted with the covering member, and fixedly maintains the state in which the spinous process is sandwiched between the bending portion of the pendulum member and the bending portion of the covering member.
It is set as the characteristic characterized by this.

  According to the above configuration, the necessary cuticle is provided on the side surface of the cervical vertebra, and the pendulum member, the covering member, and the stopper member are sequentially inserted between the spinous processes from there to enlarge and fix the adjacent spinous processes (predetermined) Maintain the interval).

  Since the pendulum member to be inserted is pivotally supported at the tip of the rod member, when inserting between the spinous processes, the longitudinal direction of the pendulum member can be aligned with the longitudinal direction of the rod member, and inserted with a small skin incision. Can do. After the pendulum member passes between the spinous processes, the pendulum member is rotated using a moment force that utilizes the portion that contacts the side surface of the spinous process so that the longitudinal direction of the pendulum member intersects the longitudinal direction of the rod member Then, the curved portion is brought into contact with the adjacent spinous process. At this time, the portion where the curved portion of the pendulum member comes into contact with the adjacent spinous process is a portion located on the back (back) side when the adjacent spinous process is viewed from the insertion direction of the rod member.

  Further, since the covering member to be inserted next to the pendulum member is provided with the connecting shaft guide hole, the rod member can be inserted as a guide, and since the connecting shaft movable groove is provided, the longitudinal direction of the covering member is The posture can be adjusted to face the axial direction of the connecting shaft, and when inserted between the spinous processes, the longitudinal direction of the covering member can be aligned with the longitudinal direction of the rod member, and it is inserted with a small skin incision like the pendulum member be able to. The covering member uses an instrument such as a clamp to rotate the covering member so that the longitudinal direction of the covering member intersects the longitudinal direction of the rod member, thereby bringing the curved portion into contact with the adjacent spinous process. At this time, the portion where the curved portion of the covering member contacts the adjacent spinous process is a portion located on the front (front) side when the adjacent spinous process is viewed from the insertion direction of the rod member.

  Then, a stopper member that can be fixed to the connecting shaft is fitted or brought into contact with the covering member to fix and maintain a state in which the spinous process is sandwiched between the bending portion of the pendulum member and the bending portion of the covering member.

  The connecting shaft of the rod member serves to connect the pendulum member, the cover member, and the stopper member. Finally, the rod members other than the connecting shaft are removed from the patient's body.

  Thus, according to the spinous process fixture of the present invention, adjacent spinous processes of the cervical vertebra can be fixed by a smaller skin incision, and a less invasive treatment method can be realized.

  Here, the pendulum member in the spinous process fixture of the present invention preferably has a pivot support position formed on a bisector on the hypotenuse side of a substantially right triangular prism, and a short side surface of the pendulum member hits a substantially half circumference of the spinous process. The curved portion that can contact, and the side surface is rounded in an arc shape so that the pendulum member can easily rotate when the pendulum member passes between adjacent spinous processes, and the long side surface is approximately 1/3 of the spinous process. It is set as the structure by which the curved part which can contact | abut to 1/4 circumference is provided.

  According to such a configuration of the pendulum member, after the pendulum member passes between the spinous processes, the pendulum member is rotated using a moment force utilizing a portion in contact with the side surface of the spinous process, and the longitudinal direction of the pendulum member is a rod. It is easy to adjust the posture so as to intersect the longitudinal direction of the member, and to bring the curved portion of the pendulum member into contact with the adjacent spinous process, and the convenience of the spinous process fixture of the present invention is improved.

  That is, the pendulum member has a pivotal support position formed on the bisector of the hypotenuse side of the substantially right triangular prism that is the shape of the pendulum member, and the short side surface is rounded in an arc shape. When the rod member is inserted into the rod member, the apex direction of the slanted side and the long side of the substantially right triangular prism is aligned with the rod member insertion direction, and the pendulum member passes between the spinous processes, and then the left side of the rod member insertion direction. Using the moment force that utilizes the part of the spinous process that contacts the back (back) side, the pendulum member is rotated clockwise about the pivot position, and the longitudinal direction of the pendulum member intersects the longitudinal direction of the rod member. Thus, the posture of the pendulum member is adjusted.

  Further, the pendulum member has a configuration in which a curved portion that can be brought into contact with approximately half the circumference of the spinous process on the short side surface and a curved portion that can be brought into contact with about 1/3 to 1/4 of the spinous process on the long side surface are provided. Therefore, when the pendulum member is rotated clockwise around the pivot support position and the posture of the pendulum member is adjusted so that the longitudinal direction of the pendulum member intersects the longitudinal direction of the rod member, the bending portion is It becomes easy to contact the adjacent spinous processes.

As described above, after the pendulum member passes between the spinous processes, the pendulum member is pivotally supported by using the moment force utilizing the portion of the rod member in contact with the back (back) side of the left spinous process in the insertion direction. Since the posture of the pendulum member is adjusted so that the longitudinal direction of the pendulum member intersects the longitudinal direction of the rod member, the curved portion on the short side surface is inserted into the rod member first. It will contact the spinous process located on the left side of the direction.
A relatively deep curved portion is formed on the short side surface so as to be able to contact substantially half of the spinous process, while the long side surface is capable of contacting approximately 1/3 to 1/4 of the spinous process. A relatively shallow curved portion is formed because the deep curved portion on the short side surface is in firm contact with the left spinous process in the insertion direction of the rod member, and the shallow curved portion on the long side surface is formed on the rod member. This is because the right spinous process in the insertion direction and the adjacent spinous process can be contacted with a high degree of freedom so as to be adjustable.

  In the above-described configuration of the pendulum member, the covering member in the spinous process fixture according to the present invention is preferably configured such that the curved portion formed on the side facing the curved portion that can contact substantially the half circumference of the pendulum member is the spinous process. The curved portion formed on the side facing the curved portion that can be brought into contact with the substantially 1/3 to 1/4 circumference of the pendulum member is substantially the spinous process. It is set as the structure which can contact | abut a half circumference.

  A relatively deep curved portion that can be brought into contact with the substantially half circumference of the spinous process formed on the short side surface of the pendulum member, and a contact with the substantially 1/3 to 1/4 circumference of the spinous process formed on the covering member. Formed on the covering member, and a relatively shallow curved portion that can be brought into contact with approximately 1/3 to 1/4 of the spinous process formed on the long side surface of the pendulum member. When the curved portion that can come into contact with the substantially half circumference of the spinous process faces each other, the spinous process can be firmly and stably sandwiched.

Here, in the above-mentioned covering member, it is set as the structure by which the recessed part which can be engaged with the instrument for clamping is provided in the side surface of the curved part which can contact | abut substantially 1/3-1/4 circumference of a spinous process.
As described above, when the covering member is provided between the spinous processes, the posture of the covering member can be adjusted so that the longitudinal direction of the covering member faces the axial direction of the connecting shaft because the connecting shaft has a movable groove. The longitudinal direction can be aligned with the longitudinal direction of the rod member, and the covering member is rotated so that the longitudinal direction of the covering member intersects the longitudinal direction of the rod member to bring the curved portion into contact with the adjacent spinous process. Is possible.

  Since a clamping device such as a clamp is used when adjusting the posture of the covering member with respect to the rod member, a recess that can be engaged with the clamping device is provided to improve the convenience of handling the device. In addition, the concave portion that can be engaged with the clamping device is provided on the side surface of the curved portion that can come into contact with approximately 1/3 to 1/4 of the spinous process, in order to handle the clamping device when aligning the covering member. It is taken into consideration. That is, since the insertion direction of the covering member is inserted starting from the curved portion that can be brought into contact with the substantially half circumference of the spinous process, the concave portion that can be engaged with the clamping device is approximately 1/3 to 1/4 of the spinous process. By providing it on the side surface of the curved portion that can come into contact with the circumference, the clamping device is handled so that a force is applied in a relatively pulling direction, and the safety can be further improved.

Next, in the spinous process fixture of the present invention, specifically, a screw thread is formed on the connecting shaft, and the stopper member is provided with a through hole for the connecting shaft, and the portion that can be fitted to the covering member and the connecting shaft It is preferable that it is comprised from the nut part which can be screwed together.
A screw thread is formed on the connecting shaft, and the stopper member is provided with a nut portion that can be screwed with the connecting shaft, so that the stopper member can be fixed to the connecting shaft. Since the stopper member is provided with the through hole for the connecting shaft, it can be conveyed to the surgical field using the rod member as a guide.

Here, in the stopper member, the shape of the portion that can be fitted with the covering member is preferably a substantially hemispherical shape or a truncated cone shape.
By forming the portion of the stopper member that can be fitted with the covering member into a substantially hemispherical or truncated cone shape, the interval between the pendulum member and the covering member can be reduced without changing the posture of the covering member.

Moreover, it is preferable that the spinous process fixture of the present invention further includes a nut member that can be used after the stopper member is fixed to the connecting shaft and can be screwed with the connecting shaft.
Stability is improved by attaching a nut member that can be screwed to the connecting shaft to the stopper member.

In order to remove rod members other than the connecting shaft after attaching the stopper member or nut member, it is more preferable to reduce the rod diameter at the boundary portion of the rod member with the connecting shaft.
The connecting shaft of the rod member serves to connect the pendulum member, the cover member, and the stopper member, and the rod member other than the connecting shaft is finally removed from the patient's body. By making the rod diameter smaller, cutting of the extra rod member (such as excision by threading the rod member) can be facilitated.

Any or all of the rod member, the pendulum member, the covering member, and the stopper member in the spinous process fixture of the present invention are ceramic materials selected from alumina, zirconia, hydroxyapatite, and calcium phosphate, and a calcium phosphate glass material having bioactivity. More preferably, it is made of a resin material, a plastic material, or a metal material selected from stainless steel, titanium, and a titanium alloy.
In particular, among the above, when composed of a bioactive material such as hydroxyapatite, calcium phosphate, or calcium phosphate glass material, direct bonding with natural bone is possible.

  With the spinous process fixture according to the present invention, it is possible to fix between spinous processes transcutaneously or minimally invasively even under local anesthesia. For this reason, it can be expected that the patient has an early effect after surgery, and a day-trip operation is also possible, which may further reduce the time and physical burden.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

FIG. 1 is an external view (perspective view) of the spinous process fixture according to the first embodiment. As shown in FIG. 1, the spinous process fixture 1 according to the first embodiment includes a rod member 2, a pendulum member 3, a covering member 4, and a stopper member 5, and curved portions (3 a and 3 b) of the pendulum member 3. And the spinous process adjacent to the gap between the curved portion (4a, 4b) of the covering member 4 is used.
Hereinafter, the rod member 2, the pendulum member 3, the covering member 4, and the stopper member 5 will be described in detail.

FIG. 2 shows the rod member 2 and the pendulum member 3.
The pendulum member 3 is pivotally supported on the connecting shaft 2 a at the tip of the rod member 2. The pendulum member 3 has curved portions (3a, 3b) formed at portions facing each other with the shaft support position 3c interposed therebetween. The interior of the pendulum member 3 is perforated so that the pendulum member 3 can rotate around the pivot support position 3c, and a space 3d is provided.

  The rod member 2 includes a connecting shaft 2a at the tip and a rod portion 2b other than the connecting shaft. The boundary portion 2c between the connecting shaft 2a and the rod portion 2b has a small diameter and is easily broken at the boundary portion 2c. Further, the connecting shaft 2a of the rod member 2 is provided with a screw thread, and a nut portion (not shown) of a stopper member, which will be described later, is screwed into the screw thread portion, so that the stopper member can be arbitrarily connected to the connecting shaft 2a. The structure can be fixed to the position.

Next, the shape and characteristics of the pendulum member 3 will be described. FIG. 3A shows a front view, a plan view, and a rear view showing the shape of the pendulum member 3.
As can be seen from the plan view of FIG. 3 (1) and the reference plan view of FIG. 3 (2), the pendulum member 3 has a pivot support position 3c formed on a bisector on the oblique side 3e side of the substantially right triangular prism, On the short side surface, there are provided a curved portion 3a having a substantially semicircular deep curve and a side surface 3f having an arcuate round bulge. Moreover, the curved part 3b of the shallow curve of about 1/3-1/4 circumference is provided in the long side surface.

With reference to FIG. 4, the manner in which the curved portions (3a, 3b) of the pendulum member 3 abut between adjacent spinous processes will be described.
When the pendulum member 3 is inserted between the adjacent spinous processes (6a, 6b), the longitudinal direction of the pendulum member 3 is aligned with the longitudinal direction of the rod member 2, and is inserted into the gap between the adjacent spinous processes. When the distal end of the connecting shaft 2a and the pendulum member 3 pass between the adjacent spinous processes (6a, 6b), the pendulum member 3 is pivotally supported by the moment force utilizing the portion contacting the side surface of the spinous process 6a. It rotates clockwise around the position 3c (see FIG. 4 (1)).
That is, when the side surface of the spinous process 6a and the side surface 3f of the pendulum member 3 are in contact with each other, pulling the rod member 2 toward the front generates a clockwise moment force about the pivot position 3c as the center of the moment, and the pendulum member 3 rotates. To do. As described above, the side surface 3f of the pendulum member 3 has an arcuate round bulge so that the pendulum member 3 can easily rotate.

  By the moment force, the posture is adjusted so that the longitudinal direction of the pendulum member 3 intersects the longitudinal direction of the rod member 2, and the curved portions (3a, 3b) of the pendulum member 3 are placed on the adjacent spinous processes (6a, 6b). It comes into contact (see FIG. 4 (2)). The portion where the curved portion (3a, 3b) of the pendulum member 3 abuts on the adjacent spinous process (6a, 6b) is the back (back) when the adjacent spinous process (6a, 6b) is viewed from the insertion direction of the rod member 2. It becomes the part located on the side.

Next, the covering member 4 will be described with reference to FIG. FIG. 5A shows a front view, a plan view, and a rear view showing the shape of the covering member 4. FIG. 5B is an external view (perspective view) of the covering member 4. As shown in the plan view of FIG. 5 (1), the covering member 4 has a deep curved end (end shaped like a birdcage) 4c, and approximately 1/3 to 1/4 on the side surface. A curved portion 4a having a shallow circumference and a curved portion 4b having a substantially semicircular deep curve formed inside the curved end portion 4c are provided.
Further, the covering member 4 is formed with a connecting shaft guide hole (4e, 4f) and a connecting shaft movable groove (4f, 4g), and the rod member 2 is inserted using the connecting shaft guide hole (4e, 4f). Further, since the connecting shaft movable groove (4f, 4g) is provided, the posture of the covering member 4 can be adjusted. The posture adjustment of the covering member 4 is performed by pinching the side depression 4i with a clamping device such as a clamp.

Here, the attitude adjustment of the covering member 4 will be described with reference to FIGS.
The covering member 4 is formed with the connecting shaft movable grooves (4f, 4g) in addition to the connecting shaft guide holes (4e, 4f), so that the longitudinal direction of the covering member 4 is the longitudinal direction of the connecting shaft 2a. The covering member can be rotated so as to intersect with. That is, if only the connecting shaft guide holes (4e, 4f) are present in the covering member 4, the connecting shaft 2a penetrates the covering member 4 as shown in FIG. 6 (1). If the diameter of the cover member 4 is slightly larger than the diameter of the connecting shaft 2a, it is difficult to change the posture of the covering member 4.
However, since the connecting shaft movable grooves (4f, 4g) are formed, the posture can be changed as shown in FIG. 6 (2). The covering member is arranged so that the longitudinal direction of the covering member 4 intersects the longitudinal direction of the connecting shaft 2a so that the deep curved end portion (end portion like a birdcage shape) 4c faces the insertion direction of the rod member 2. The cover member 4 can be inserted with a small skin incision like the pendulum member 3.

  As shown in FIG. 6 (3), the covering member 4 is moved using a clamping device such as a clamp 7 to change the posture with respect to the connecting shaft 2a. In this case, the longitudinal direction of the connecting shaft movable grooves (4f, 4g) is such that the deep curved end (end shaped like a birdcage) 4c faces the insertion direction of the rod member 2 in the longitudinal direction. It is set to the direction which points the front-end | tip of the part (end part shaped like a birdcage) 4c.

  Next, the stopper member 5 will be described with reference to FIG. FIG. 7 shows an external view of the stopper member 5 (a front view and a perspective view seen from the bottom side). The stopper member 5 includes a head portion 5a and a nut portion 5b, and has a screw hole at the center. The head 5 a has a dome shape and can be fitted into a dome-shaped recess provided around the connecting shaft guide hole of the covering member 4. The central screw hole of the stopper member 5 can be screwed into the connecting shaft 2a of the rod member 2 and can be fixed to the connecting shaft 2a.

As described above, the rod member 2, the pendulum member 3, the covering member 4, and the stopper member 5 have been individually described with respect to the spinous process fixture. However, as shown in FIG. 8, the adjacent spinous processes (6 a and 6 b) are combined. ) Is fixed and maintained.
The size of the spinous process fixture is designed as follows, for example, when used for fixing the cervical spinous process. First, it is appropriate that the pendulum member 3 has a longitudinal direction of about 30 mm and a thickness of about 6 mm. Further, regarding the diameter and length of the rod member 2, particularly the connecting shaft 2a, it is appropriate that the diameter is 3 mm and the length is about 15 mm. Moreover, the longitudinal direction of the covering member 4 is about 25 mm, which is slightly shorter than the pendulum member 3, and a thickness of about 6 mm is appropriate. However, since these sizes vary depending on individual differences and places to be inserted, several sizes are prepared and appropriate sizes are determined by preoperative measurement. Further, these materials are preferably metallic in view of the complicated shape and strength.

Next, how to use the spinous process fixture will be described with reference to FIG. First, the method of using the rod member 2 and the pendulum member 3 (method of inserting between the spinous processes) has already been described (see the description of FIG. 4). FIG. 9 (1) shows a state in which the covering member 4 is brought close to the pendulum member 3 via the rod member 2b.
The covering member 4 is tilted by using the connecting shaft movable groove, and is inserted toward the arrow A in the figure with the tip of the curved end (end shaped like a birdcage) 4c at the top. The Using the clamp 7, the recess 4 i at the rear part (opposite side of 4 c) is grasped and the posture of the cover member 4 is adjusted. The covering member 4 uses a clamp 7 to rotate the covering member 4 so that the longitudinal direction of the covering member 4 intersects the longitudinal direction of the rod member 2, and the curved portion is formed into an adjacent spinous process (not shown). Contact (state (2) in FIG. 9).

Further, as shown in FIG. 9 (2), the stopper member 5 is screwed into the connecting shaft 2a. The nut driver 8 is used to move as indicated by the arrow D in FIG. 9B, and the stopper member 5 is pushed in the direction of the arrow C.
Finally, as shown in FIG. 9 (3), the pendulum member 3, the covering member 4, and the stopper member 5 are connected via the connecting shaft 2a. Excess rod members other than the connecting shaft 2a are removed by threading where the diameter of the boundary portion is small. In addition, titanium metal is frequently used as a material that can be threaded.

  The present invention may be carried out in other specific ways than those set forth herein without departing from the scope and essential characteristics of the invention. In one embodiment, the spinous process fixture according to the present invention is used to fix between all adjacent spinous processes, such as the lumbar spine, regardless of the cervical spine.

  However, the present invention may be applied to create a space in another body tissue (enlarging and fixing the distance between bones). The above embodiments should be considered in all respects without limitation, and all changes that come within the meaning and range of equivalency of the claims are intended to be embraced therein. .

  The spinous process fixture according to the present invention can be expected to be used as an implant useful for surgical treatment for cervical spondylotic myelopathy and the like.

External view (perspective view) of the spinous process fixture of Example 1 Explanatory drawing of rod member and pendulum member Front view, plan view and rear view showing the shape of the pendulum member Explanatory drawing about a mode that the curved part of a pendulum member contact | abuts between adjacent spinous processes. Explanation of cover member Explanatory drawing about attitude adjustment of a covering member Illustration of stopper member The image figure which the spinous process fixing tool of Example 1 fixes and maintains an adjacent spinous process. Illustration of how to use spinous process fixture Image of conventional spinous process fixture Components of conventional spinous process fixtures Explanatory drawing of how to use a conventional spinous process fixture

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Spinous process fixing tool 2 Rod member 2a Connecting shaft 3 Pendulum member 3a, 3b Bending part 3c Axial support position 4 Cover member 4a, 4b Bending part 4e, 4h Connecting shaft guide hole 4f, 4g Connecting shaft movable groove 5 Stopper member 6a, 6b, 10 Spinous process 7 Clamp 8 Nut driver

Claims (9)

A rod member provided with a connecting shaft, a pendulum member capable of coming into contact with an adjacent spinous process pivotally supported at the distal end of the connecting shaft, and an adjacent spinous process provided with a connecting shaft guide hole and a connecting shaft movable groove. It is composed at least of a covering member that can come into contact with and a stopper member that can be fixed to the connecting shaft,
1) The pendulum member is formed with a curved portion at a portion facing the shaft support position, and the bent portion rotates when the tip end portion of the connecting shaft and the pendulum member pass between adjacent spinous processes. The curved portion can move against the adjacent spinous process,
2) The covering member is formed with a curved portion capable of coming into contact with the adjacent spinous process at a portion facing the connecting shaft guide hole, passed from the connecting shaft guide hole to the connecting shaft, and covered by the connecting shaft movable groove. The posture can be adjusted so that the longitudinal direction of the member faces the axial direction of the connecting shaft,
3) The stopper member can be fitted or abutted with the covering member, and fixedly maintains the state in which the spinous process is sandwiched between the bending portion of the pendulum member and the bending portion of the covering member.
A spinous process fixture characterized by the above.   The pendulum member has a pivot support position formed on a bisector on the hypotenuse side of a substantially right triangular prism, a curved portion capable of abutting a substantially half circumference of the spinous process on the short side surface, and a pendulum member between adjacent spinous processes. The side surface is rounded so that the pendulum member can easily rotate when it passes through, and a curved portion that can abut on approximately 1/3 to 1/4 of the spinous process is provided on the long side surface. The spinous process fixture according to claim 1, wherein the spinous process fixture is provided.   In the covering member, a curved portion formed on a side surface facing a curved portion that can come into contact with a substantially half circumference of the pendulum member can come into contact with a substantially 1/3 to 1/4 circumference of a spinous process, and the pendulum The curved portion formed on the side surface facing the curved portion that can be brought into contact with approximately 1/3 to 1/4 of the circumference of the member can be brought into contact with substantially half of the spinous process. Spinous process fixture.   The concave part which can be engaged with the instrument for clamping is provided in the side surface of the curved part which can contact | abut substantially 1/3-1/4 circumference of the spinous process in the said covering member. Spinous process fixture. A screw thread is formed on the connecting shaft,
2. The barb according to claim 1, wherein the stopper member is provided with a through hole for a connecting shaft, and includes a portion that can be fitted to the covering member and a nut portion that can be screwed to the connecting shaft. Protrusion fixture.   6. The spinous process fixture according to claim 5, wherein a shape of a portion where the stopper member can be fitted with the covering member is a substantially hemispherical shape or a truncated cone shape.   6. The spinous process fixture according to claim 5, further comprising a nut member that is used after the stopper member is fixed to the connecting shaft and that can be screwed with the connecting shaft.   The rod diameter at the boundary portion between the rod member and the connecting shaft is reduced in order to remove the rod member other than the connecting shaft after the stopper member or the nut member is attached. Spinous process fixture.   Any or all of the rod member, pendulum member, covering member and stopper member are ceramic materials selected from alumina, zirconia, hydroxyapatite, calcium phosphate, bioactive calcium phosphate glass materials, resin materials, plastic materials, The spinous process fixture according to any one of claims 1 to 8, wherein the spinous process fixture is made of a metal material selected from stainless steel, titanium, and a titanium alloy.