JP2009505745A - 骨構造を最小侵襲で安定させるための器具 - Google Patents
骨構造を最小侵襲で安定させるための器具 Download PDFInfo
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- A61B17/7089—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements wherein insertion is along an arcuate path
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Abstract
Description
別の形態において、取付器具は、簡便に、および遠隔式に接続要素を挿入器具と係合および係合解除できるクイックリリース作動機構を含む。
本発明の関連する特徴、態様、実施形態、目的および利点は以下の記載から明らかになるであろう。
図20Cは、アンカーに固定されているアンカー延長部を示す斜視図である。
Claims (34)
- 患者の体内での最小侵襲外科処置のためのシステムにおいて、
それぞれが細長い本体を含むいくつかのアンカー延長部であって、前記本体は遠位端および近位端の間に延在し、患者の骨構造に係合される少なくとも1つのアンカーに対して前記遠位端が装着されるときに、前記近位端が前記患者の外側に配置されるような長さを前記本体が有する、いくつかのアンカー延長部と、
第1および第2支持腕部を含む取付器具であって、前記第1および第2支持腕部のそれぞれが外部の係合端部を含み、前記第1および第2支持腕部のそれぞれが、前記係合端部から共通の接合部まで延在し、前記取付器具は挿入具腕部をさらに含み、前記挿入具腕部は、前記接合部から前記第1および第2支持腕部に対して横向きに延在し、前記第1および第2支持腕部の少なくとも1つが、前記接合部に対して枢動結合され、且つ前記支持腕部の前記係合端部の間の空間を可動的に調整して、前記近位端に隣接する前記いくつかのアンカー延長部の両側と係合する、取付器具と、
前記患者の身体内に植え込むための接続要素であって、前記挿入具腕部に係合される、接続要素と、を備えるシステム。 - 前記いくつかのアンカー延長部が2つのアンカー延長部を含み、前記アンカー延長部のそれぞれが、その前記遠位端に対して解放可能に係合されるアンカーを含む、請求項1に記載のシステム。
- 前記いくつかのアンカー延長部が3つのアンカー延長部を含み、前記アンカー延長部のそれぞれが、その前記遠位端に対して解放可能に係合されるアンカーを含む、請求項1に記載のシステム。
- 前記第1および第2支持腕部の前記係合端部のそれぞれが、前記いくつかのアンカー延長部に対して回転可能に係合される、請求項1に記載のシステム。
- 前記支持腕部の間に係合されるクランプ機構をさらに備え、前記クランプ機構が、前記第1支持腕部に結合された第1端部と前記第2支持腕部に結合された第2端部との間に延在するクランプ腕部を含み、前記第1端部が当該第1端部に結合されるレバーを含み、前記レバーは、前記係合端部の間で前記いくつかのアンカー延長部を受ける開放位置から、前記係合端部の間に前記アンカー延長部をクランプ留めする閉鎖位置まで可動であり、前記閉鎖位置を維持するために、前記クランプ腕部が前記レバーを付勢する、請求項1に記載のシステム。
- 前記第2支持腕部が前記接合部に枢動結合され、前記第1支持腕部が前記接合部に対して固定され、前記クランプ腕部の前記第2端部が前記第2支持腕部に対して回転可能に装着される車輪に枢動結合される、請求項5に記載のシステム。
- 前記クランプ腕部の第2端が、前記車輪の回転の中心から半径方向にずれた位置で前記車輪に枢動結合される、請求項6に記載のシステム。
- 前記支持腕部の前記係合端部のそれぞれが、前記支持腕部の間に係合部材を含み、前記係合部材のそれぞれが前記支持腕部のそれぞれに対して枢動的に装着される、請求項1に記載のシステム。
- 前記挿入具腕部および前記接続要素が湾曲した挿入軸に沿って延在し、前記湾曲した挿入軸は、前記支持腕部と前記いくつかのアンカー延長部との接続部に画定される回転中心を有する、請求項1に記載のシステム。
- 患者の体内での最小侵襲外科処置のためのシステムにおいて、
それぞれが細長い本体を含むいくつかのアンカー延長部であって、前記本体が遠位端および近位端の間に延在し、前記患者の骨構造に係合される少なくとも1つのアンカーに対して前記遠位端が装着されるときに、前記近位端が患者の外側に配置されるような長さを前記本体が有する、いくつかのアンカー延長部と、
前記患者の体内に植え込むための接続要素と、
装着部および挿入具腕部を含む取付器具であって、前記装着部が、前記いくつかのアンカー延長部に係合可能であり、前記装着部に対して横向きに方向付けられる軸に沿って、前記挿入具腕部が前記装着部から延在し、前記挿入具腕部が、内部に細長い固定部材を有する穴を含み、前記固定部材が、前記挿入具腕部の遠位端に隣接する固定端部と、前記挿入具腕部の近位端に隣接する作動部材に対して結合される反対側の端部との間に延在し、
前記作動部材は、非ロック位置からロック位置への間で移動するために、前記取付器具に対して枢動的に装着されており、前記非ロック位置では、前記固定端部が前記挿入具腕部の前記遠位端から突出して、前記接続要素を受け、前記ロック位置では、前記作動部材が前記固定端部を前記挿入具腕部の前記穴の中に移動させ、前記接続要素を前記固定端部に係合するために、前記固定部材が前記穴の中に移動される際、前記挿入具腕部が前記固定部材に係合する、取付器具と、を備えるシステム。 - 前記固定部材が前記固定端部にコレットを含み、前記作動部材が前記ロック位置に移動されるとき前記接続要素に係合するために前記挿入具腕部が前記コレットを押しつける、請求項10に記載のシステム。
- 前記接続要素が、延長され且つ挿入先端部と後端部との間に延在し、前記固定部材が前記後続端部に係合され、前記接続要素が前記挿入具腕部の前記軸に沿って延在する、請求項10に記載のシステム。
- 前記作動部材が、前記固定部材の前記反対側端部に対して解放可能に係合されるラッチ機構に結合される、請求項10に記載のシステム。
- 前記作動部材が前記非ロック位置にあるときに、前記ラッチ機構は非ラッチ位置とラッチ位置との間で可動であり、前記非ラッチ位置では、内部で前記固定部材の前記反対側端部を受け取り且つ取り外し、前記ラッチ位置は、内部で前記固定部材の前記反対側端部に係合する、請求項13に記載のシステム。
- 前記ラッチ機構が、前記作動部材に装着される筐体と、前記筐体に結合されるラッチ部材とを含み、前記ラッチ部材は、前記ラッチ位置と前記非ラッチ位置との間で、前記筐体に対して可動である、請求項14に記載のシステム。
- 前記固定部材の前記反対側端部が、拡大された頭部と一対の切欠部とを含み、前記一対の切欠部が、前記拡大された頭部と前記固定部材の本体との間にあり、前記ラッチ部材がラッチ突出物を含み、前記ラッチ部材が前記ラッチ位置にあるときに、前記ラッチ突出物が、前記切欠部のそれぞれの中で受けられる、請求項15に記載のシステム。
- 前記ラッチ部材が上方端部を含み、前記筐体に対して枢動結合された下方ラッチ端部の周りで、前記筐体に向かって且つ前記筐体から離れて、前記上方端部が枢動し、前記下方ラッチ端部が対向する指状部を含み、前記指状部が当該指状部の間に空間を画定し、前記空間が開口部を有し、前記非ラッチ位置にあるときに、前記拡大された頭部が前記開口部を通るように前記開口部のサイズが決められる、請求項16に記載のシステム。
- 前記挿入具腕部がいくつかの開口を含み、前記開口が、前記装着部と前記遠位端との間でその長さに沿って離間され、前記開口が前記挿入具腕部の前記穴と連通する、請求項10に記載のシステム。
- 患者の体内での最小侵襲外科処置のためのシステムにおいて、
それぞれが細長い本体を含むいくつかのアンカー延長部であって、前記本体は遠位端および近位端の間に延在し、前記患者の骨構造に係合される少なくとも1つのアンカーに対して前記遠位端が装着されるときに、前記近位端が患者の外側に配置されるような長さを有する、いくつかのアンカー延長部と、
前記患者の体内に植え込むための接続要素と、
装着部および挿入具腕部を含む取付器具であって、前記装着部が、前記いくつかのアンカー延長部に係合可能であり、前記装着部に対して横向きに方向付けられる軸に沿って、前記挿入具腕部が前記装着部から延在し、前記挿入具腕部が内部に細長い固定部材を含み、前記固定部材が、前記挿入具腕部の遠位端に隣接する固定端部と、前記挿入具腕部の近位端でラッチ機構に結合される反対側の端部との間で延在しており、前記ラッチ機構が、前記取付器具に装着される筐体および前記筐体に結合されるラッチ部材を含み、前記ラッチ部材が、非ラッチ位置およびラッチ位置の間で前記筐体に対して可動であり、前記非ラッチ位置では、前記固定部材の前記反対側の端部が、前記筐体内に挿入され且つ前記筐体から引き出すことができ、前記ラッチ位置では、前記ラッチ部材が前記反対側端部を前記筐体内にロックする、取付器具と、を備えるシステム。 - 前記ラッチ機構が作動部材に結合され、非ロック位置およびロック位置の間で前記固定部材が移動するために、前記作動部材が前記取付器具に対して枢動的に装着され、前記非ロック位置では、前記固定部材の固定端部が前記挿入具腕部の前記遠位端から突出して、前記接続要素を受け、前記ロック位置では、前記固定端部が前記挿入具腕部の前記穴の中に移動され、前記接続要素を前記固定端部に係合するために、前記固定部材が前記穴の中に移動される際、前記挿入具腕部は前記固定部材に係合する、請求項19に記載のシステム。
- 前記固定部材の前記反対側端部が、拡大された頭部と一対の切欠部とを含み、前記一対の切欠部が、前記拡大された頭部と前記固定部材の本体との間にあり、前記ラッチ部材がラッチ突出物を含み、前記ラッチ部材が前記ラッチ位置にあるときに、前記ラッチ突出部が前記切欠部のそれぞれの中で受けられる、請求項20に記載のシステム。
- 前記ラッチ部材が上方端部を含み、前記筐体に対して枢動結合された下方ラッチ端部の周りで、前記筐体に向かって且つ前記筐体から離れて、前記上方端部が枢動し、前記下方ラッチ端部が腕部を含み、前記腕部が空間を前記腕部の間に画定し、前記空間が受け部を有し、前記ラッチ部材が前記非ラッチ位置にあるときに、前記受け部を通って前記拡大された頭部を受けるように前記受け部のサイズが決められ、前記ラッチ部材が前記ラッチ位置に枢動される際、前記切欠部内に配置されるために、前記ラッチ突出物が前記受け部に隣接する、請求項21に記載のシステム
- 外科手術システムにおいて
骨係合部および接続要素係合部を含むアンカーと、
前記接続受け部に解放可能に係合可能であり、長手軸に沿って延在する延長部とを備えており、前記延長部は、
前記長手軸に沿った内部スリーブであって、前記接続要素係合部に係合可能な一対の遠位の指状部を含む、内部スリーブと、
前記内部スリーブの周りで前記長手軸に沿う外部スリーブであって、前記外部スリーブは、第1位置から第2位置まで前記内部スリーブに対して遠位方向に可動であり、前記第1位置では、前記接続要素係合部を前記指状部の間で受け且つ解放するために、前記指状部が可動であり、前記第2位置では、前記外部スリーブが前記指状部をクランプ係合で前記接続要素係合部と係合する、外部スリーブと、
前記内部スリーブおよび前記外部スリーブの間に結合されるトグル機構であって、前記トグル機構は、ロック位置および非ロック位置の間で前記長手軸に沿って移動するように構築され、前記ロック位置では、前記内部スリーブに対して所定の位置に前記外部スリーブをロックし、前記非ロック位置では、前記トグル機構が前記内部スリーブから係合解除され前記外部スリーブが前記第1および第2位置の間で前記内部スリーブに対して可動であるる、トグル機構と、を備える外科手術システム。 - 前記外部スリーブが、前記軸に沿って延在する対向する細長いスロットを含み、
前記内部スリーブが、前記遠位指状部の遠位端に近接して前記指状部上に一対の対向する突出部材を含み、前記外部スリーブが前記第1および第2位置の間で移動される際、前記突出部材が、前記スロットの対応する1つを通って延在し、且つ前記スロットの対応する1つに沿って可動である、請求項23に記載のシステム。 - 前記遠位指状部が外方に延在するフランジ付き端部を含み、前記外部スリーブが前記第2位置にあるときに、前記フランジ付き端部に隣接して配置される遠位端部を含む、請求項24に記載のシステム。
- 前記トグル機構が、前記内部および外部スリーブの間で両スリーブの近位端に隣接する本体を含み、前記トグル機構が、前記内部および外部スリーブから近位方向に延在する近位把持部を含む、請求項23に記載のシステム。
- 前記トグル機構が、前記トグル機構に前記外部スリーブを係合し、前記トグル機構を前記外部スリーブにロックし、前記トグル機構の軸方向の移動を阻止するために少なくとも1つのトグルラッチを含み、前記外部スリーブが前記少なくとも1つのトグルラッチを前記トグル機構から係合解除し、前記トグル機構の軸方向の移動を可能にするように作動可能な少なくとも1つのボタンを含む、請求項26に記載のシステム。
- 前記少なくとも1つのボタンが、前記外部スリーブから離れるように付勢された遠位端と、前記外部スリーブの前記近位端で前記トグルラッチに係合される近位端との間に延在し、前記外部スリーブの、前記遠位端および近位端の間で、前記ボタンが前記外部スリーブに枢動結合され、前記遠位端で前記付勢力に抗して前記ボタンを押すことで、前記近位端を枢動し、且つ前記トグル機構から前記トグルラッチを係合解除する、請求項27に記載のシステム。
- 前記トグル機構が前記近位把持部の遠位のカラーを含み、前記トグル機構を前記外部スリーブにロックするために、前記トグルラッチが前記カラーの近位方向に方向付けられた面に係合可能なリップを含む、請求項28に記載のシステム。
- 前記少なくとも1つのボタンおよび前記少なくとも1つのトグルラッチが、前記外部スリーブの対向する面に一対のボタンおよびトグルラッチを含む、請求項28に記載のシステム。
- 前記トグル機構が、前記外部スリーブおよび前記内部スリーブの間で延在する少なくとも1つのスリーブラッチを含み、前記スリーブラッチが前記内部スリーブの外面内の切欠部内に通常付勢される突出物を含み、前記非ロック位置に移動されると前記トグル機構が前記切欠部から前記突出物を移動させる、請求項26に記載のシステム。
- 前記トグル機構が前記スリーブラッチの内面に接触する近位方向に先細の部分を含み、前記トグル機構が前記非ロック位置に近位方向および軸方向に移動される際、前記先細の部分が前記長手軸に対して横方向に前記スリーブラッチを移動させる、請求項31に記載のシステム。
- 前記トグル機構が、前記外部スリーブおよび前記本体に係合する少なくとも1つのトグルラッチを含み、前記トグルラッチは、前記トグル機構を前記外部スリーブにロックして、前記トグル機構の軸方向の移動を阻止し、前記外部スリーブが少なくとも1つのボタンを含み、前記ボタンが、前記少なくとも1つのトグルラッチを前記本体から係合解除し、且つ前記トグル機構を開放するように作動可能である、請求項32に記載のシステム。
- 前記ボタンと前記スリーブラッチの間に延在し、通常前記内部スリーブに向かって前記スリーブラッチを付勢するばねをさらに備える、請求項33に記載のシステム。
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US11/213,473 US7695475B2 (en) | 2005-08-26 | 2005-08-26 | Instruments for minimally invasive stabilization of bony structures |
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JP2019505312A (ja) * | 2016-02-02 | 2019-02-28 | エースクラップ アーゲー | インプラントホルダ内にロッドを案内する器具 |
JP7037487B2 (ja) | 2016-02-02 | 2022-03-16 | エースクラップ アーゲー | インプラントホルダ内にロッドを案内する器具 |
Also Published As
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EP2218416A3 (en) | 2010-08-25 |
AU2006283034A1 (en) | 2007-03-01 |
KR101008466B1 (ko) | 2011-01-14 |
ES2355938T3 (es) | 2011-04-01 |
EP2218417A3 (en) | 2010-08-25 |
EP1928334A1 (en) | 2008-06-11 |
CA2620271A1 (en) | 2007-03-01 |
US8070751B2 (en) | 2011-12-06 |
AU2006283034B2 (en) | 2011-09-22 |
WO2007025058A1 (en) | 2007-03-01 |
EP2218416B1 (en) | 2012-05-09 |
DE602006018965D1 (de) | 2011-01-27 |
EP1928334B1 (en) | 2010-12-15 |
US20070049931A1 (en) | 2007-03-01 |
US20100160982A1 (en) | 2010-06-24 |
EP2218416A2 (en) | 2010-08-18 |
EP2218417A2 (en) | 2010-08-18 |
JP5058165B2 (ja) | 2012-10-24 |
US7695475B2 (en) | 2010-04-13 |
ATE556663T1 (de) | 2012-05-15 |
ATE491402T1 (de) | 2011-01-15 |
EP2218417B1 (en) | 2015-03-11 |
KR20080052612A (ko) | 2008-06-11 |
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