JP2011515193A - 脊椎に配置される折り畳み可能な装置およびそれらに関連する方法 - Google Patents
脊椎に配置される折り畳み可能な装置およびそれらに関連する方法 Download PDFInfo
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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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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Abstract
【解決手段】一実施形態では、拡張可能な装置は、脊椎融合技法に使用するために椎間板に配置されてもよいケージを備える。装置は、カニューレを使用するなどの経皮的手段によって、椎間板に装置を運ぶように製造される。さらに、本発明の装置の製造方法ばかりではなく、本発明の装置を使用するシステムおよびキットを開示する。
【選択図】図5
Description
ある実施形態では、本発明は、拡張可能な装置および方法、システムおよびそれらに関連したキットに関する。拡張可能な装置は2つの隣接身体部分の安定化および/または融合を促進するために使用されてもよい。このように、ある実施形態では、拡張可能な装置は融合ケージである。ある実施形態では、拡張可能な装置は経皮的デリバリーのために設計される。たとえば、ある実施形態では、本発明は、2つの隣接椎骨の間で選択的に拡張されることができる、脊椎間で拡張可能な装置を埋め込むための装置、方法、システムおよび/またはキットに関し、椎骨はお互いに対する位置を維持することができ、椎骨の融合を促進しながら脊椎の正常な配置を作り出す。
ある実施形態では、本発明は拡張可能な装置を身体部分に配置するための方法を含む。たとえば、一実施形態では、本発明は複数の接続されたセグメントを備える拡張可能な装置を、被検体の身体部分に配置する方法を含み、(a)第1の形態の拡張可能な装置をカニューレに配置する工程であって、複数の接続されたセグメントの複数の長手方向軸は実質的に折り畳まれていない工程と、(b)カニューレの遠位端を関心のある身体部分に付勢する工程と、(c)拡張可能な装置をカニューレを通じて関心のある身体部分に付勢する工程と、(d)複数の接続されたセグメントを関心のある身体部分で第2の形態にさせる工程であって、複数の接続されたセグメントは実質的に折り畳まれて、拡張可能な装置を拡張し、拡張された高さにし、複数の接続されたセグメントの少なくとも1つを実質的に拡張された高さに広げる工程と、を含む。
他の実施形態では、本発明は、身体部分に配置するための拡張可能な装置を含むシステムおよびキットを含む。ある実施形態では、本発明のキットのシステムは(a)複数のセグメントを備える拡張可能な装置であって、該複数のセグメントは連続して柔軟に結合され、該拡張可能な装置は複数のセグメントが実質的に折り畳まれていない第1の形態と複数のセグメントが実質的に折り畳まれている第2の形態とを有し、第2の形態の拡張可能な装置の全高は、実質的に、複数のセグメントの少なくとも1つの長さである拡張可能な装置と、(b)該装置を関心のある身体部分に挿入するためのアクセス部材とを備える。いくつかの実施形態では、アクセス部材にはカニューレが含まれてもよい。また、いくつかの実施形態では、キットは使用説明書を含んでもよい。
本発明は、身体部分に配置するための拡張可能な装置を製造する方法も含む。一実施形態では、該方法は複数のセグメントを備える第1の部材を製造する工程を含む。一実施形態では、本発明は、複数の接続されたセグメントの製造工程を含む、身体部分に配置するための拡張可能な装置の製造方法を含み、複数の接続されたセグメントは連続して柔軟に結合され、拡張可能な装置は複数のセグメントが実質的に折り畳まれていない第1の形態と、複数のセグメントが実質的に折り畳まれている第2の形態とを有し、第2の形態の拡張可能な装置の全高は、実質的に、複数のセグメントの少なくとも1つの長さである。
Claims (34)
- 被検体の身体部分に配置する拡張可能な装置において、
複数のセグメントを備え、当該複数のセグメントは連続して柔軟に結合され、前記拡張可能な装置は、当該複数のセグメントが実質的に折り畳まれていない第1の形態と、当該複数のセグメントが実質的に折り畳まれている第2の形態とを有し、当該第2の形態の当該拡張可能な装置の全高が、実質的に、当該複数のセグメントの少なくとも1つの長さである、装置。 - 請求項1記載の装置において、
前記第2の形態で、前記複数のセグメントが互い違いの方向に折り畳まれている、装置。 - 請求項1記載の装置において、
前記第1の形態で、前記複数のセグメントの複数の長手方向軸が実質的に同軸である、装置。 - 請求項1記載の装置において、
前記第2の形態で、前記複数のセグメントの複数の長手方向軸が実質的に平行である、装置。 - 請求項1記載の装置において、
前記第2の形態で、前記複数のセグメントの第1のセグメントの長手方向表面が、当該複数のセグメントの第2のセグメントの長手方向表面と実質的に同一平面である、装置。 - 請求項1記載の装置において、
前記複数のセグメントは複数のヒンジによって接続され、当該複数のヒンジのそれぞれの厚さは当該複数のセグメントのそれぞれの厚さ未満である、装置。 - 請求項6記載の装置において、
前記複数のヒンジは前記複数のセグメントを前記第2の形態になるように付勢する、装置。 - 請求項1記載の装置において、
前記複数のセグメントは活性ヒンジによって接続されている、装置。 - 請求項1記載の装置において、
前記複数のセグメントを前記第2の形態になるように付勢するために、前記複数のセグメントの少なくとも2つの間に接続されている再配置部材をさらに備える、装置。 - 請求項1記載の装置において、
前記セグメントを前記第1の形態と前記第2の形態との間で付勢するための再配置部材さらに備える、装置。 - 請求項10記載の装置において、
前記再配置部材は前記セグメントのそれぞれと係合し、
前記再配置部材は装置の操作者が前記セグメントを前記第1の形態から前記第2の形態へ付勢するために、または前記第2の形態から前記第1の形態へ付勢するために使用することができる、装置。 - 請求項11記載の装置において、
前記再配置部材はそれぞれのセグメント上の少なくとも1つの開口部を通過するワイヤを含む、装置。 - 請求項1記載の装置において、
前記装置が前記第2の形態の場合に、前記セグメントの配置を支援する要素をさらに備える、装置。 - 請求項1記載の装置において、
前記身体部分は椎間板または2つの椎体の間の椎間領域を含む、装置。 - 複数の接続されたセグメントを備える拡張可能な装置を被検体の身体部分に配置する方法であって、
(a)第1の形態で前記拡張可能な装置をカニューレの中に配置する工程であって、前記複数の接続されたセグメントの複数の長手方向軸が実質的に折り畳まれない工程と、
(b)前記カニューレの遠位端を関心のある前記身体部分に付勢する工程と、
(c)前記拡張可能な装置を前記カニューレを通じて関心のある前記身体部分に付勢する工程と、
(d)前記複数の接続されたセグメントを関心のある前記身体部分で第2の形態にさせる工程であって、前記複数の接続されたセグメントは実質的に折り畳まれ、前記拡張可能な装置を拡張された高さに拡張し、前記複数の接続されたセグメントの少なくとも1つは実質的に前記拡張された高さである工程と、を含む、方法。 - 請求項15記載の方法において、
前記第1の形態で、前記複数の接続されたセグメントの前記複数の長手方向軸が実質的に同軸である、方法。 - 請求項15記載の方法において、
前記第2の形態で、前記複数の接続されたセグメントの前記複数の長手方向軸が実質的に平行である、方法。 - 請求項15記載の方法において、
前記第2の形態で、前記複数の接続されたセグメントの第1のセグメントの長手方向表面が、前記複数の接続されたセグメントの第2のセグメントの長手方向表面と実質的に同一平面である、方法。 - 請求項15記載の方法において、
前記複数の接続されたセグメントは複数のヒンジによって接続され、前記複数のヒンジのそれぞれの厚さは前記複数の接続されたセグメントのそれぞれの厚さよりも薄い、方法。 - 請求項15記載の方法において、
前記複数の接続されたセグメントは活性ヒンジによって接続されている、方法。 - 請求項15記載の方法において、
前記拡張可能な装置は、前記セグメントを前記第1の形態と前記第2の形態との間で付勢するための再配置部材をさらに備える、方法。 - 請求項15記載の方法において、
前記複数の接続されたセグメントを前記第2の形態にさせる工程は、前記複数の接続されたセグメントの遠位セグメントと、前記複数の接続されたセグメントの近位セグメントとを共に近づくように移動させる工程を含む、方法。 - 請求項15記載の方法において、
前記拡張可能な装置は、少なくとも2つのセグメントの前記長手方向表面が実質的に同一平面となるとき、前記セグメントの配置を支援する要素をさらに備える、方法。 - 請求項15記載の方法において、
前記身体部分は椎間板または2つの椎体の間の椎間領域を含む、方法。 - 請求項15記載の方法において、
装置が配置された後に、展開された拡張可能な装置の上部表面に隣接する椎体と、前記展開された拡張可能な装置の下部表面に隣接する椎体との融合を促進するために、骨移植片材料を配置する工程をさらに含む、方法。 - 請求項15記載の方法において、
前記複数の接続されたセグメントを第2の形態にさせる工程は、前記複数の接続されたセグメントをカニューレから排出させる工程を含む、方法。 - 身体部分に配置するための拡張可能な装置を備えるキットにおいて、
(a)複数のセグメントを備える拡張可能な装置であって、当該複数のセグメントは連続して柔軟に結合され、当該拡張可能な装置は、当該複数のセグメントが実質的に折り畳まれていない第1の形態と、当該複数のセグメントが実質的に折り畳まれている第2の形態とを有し、当該第2の形態の当該拡張可能な装置の全高は、実質的に、当該複数のセグメントの少なくとも1つの長さである拡張可能な装置と、
(b)前記装置を関心のある前記身体部分に挿入するためのカニューレと、を具備する、キット。 - 請求項27記載に記載のキットにおいて、
前記複数の接続されたセグメントは活性ヒンジによって接続されている、キット。 - 請求項27記載に記載のキットにおいて、
前記セグメントを前記第1の形態と前記第2の形態との間で付勢する再配置部材をさらに備える、キット。 - 請求項27記載に記載のキットにおいて、
前記セグメントはカニューレを使用して身体部分に経皮デリバリーするように構成される、キット。 - 請求項27記載に記載のキットにおいて、
椎間板腔に配置するための骨移植片材料をさらに含み、展開された前記拡張可能な装置の上部表面に隣接する椎体と、当該展開された拡張可能な装置の下部表面に隣接する椎体との融合を促進する、キット。 - 身体部分に配置するための拡張可能な装置を製造する方法において、
複数の接続されたセグメントを製造する工程を含み、当該複数の接続されたセグメントは連続して柔軟に結合され、前記拡張可能な装置は、前記複数のセグメントが実質的に折り畳まれていない第1の形態と、前記複数のセグメントが実質的に折り畳まれている第2の形態とを有し、前記第2の形態の前記拡張可能な装置の全高が、実質的に、前記複数のセグメントの少なくとも1つの長さである、方法。 - 請求項32記載の方法において、
それぞれのセグメントは隣接セグメントの間にある活性ヒンジによってお互いに接続されている、方法。 - 複数の接続されたセグメントを備える拡張可能な融合ケージを被検体の2つの椎体の間の椎間領域の中に配置する方法であって、
(a)前記複数の接続されたセグメントの複数の長手方向軸が実質的に同一平面にある第1の形態で、前記拡張可能な融合ケージをカニューレの中に配置する工程と、
(b)前記カニューレの遠位端を前記椎間領域に付勢する工程と、
(c)前記複数の接続されたセグメントを前記カニューレを介して前記椎間領域の中に付勢する工程と、
(d)前記複数の接続されたセグメントを通る再配置部材の全体で、前記複数の接続されたセグメントの近位セグメントと前記複数の接続されたセグメントの遠位セグメントとを一緒に近づける工程であって、前記再配置部材を引っ張って、前記複数の接続されたセグメントを第2の形態に配置させ、前記カニューレから排出された少なくとも2つのセグメントを展開して、1つのセグメントの長手方向表面が隣接セグメントの長手方向表面と実質的に同一平面となる工程と、
(e)前記拡張可能な融合ケージが前記カニューレから完全に出て、前記椎間領域で完全に展開するまで、工程(c)と工程(d)とを繰り返す工程と、
(f)任意に、骨移植片材料を添加する工程と、
(g)椎間板腔から前記カニューレを除去する工程と、を含む、方法。
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Also Published As
Publication number | Publication date |
---|---|
AU2009228922A1 (en) | 2009-10-01 |
KR20100139066A (ko) | 2010-12-31 |
EP2262435B1 (en) | 2012-11-14 |
EP2262435A1 (en) | 2010-12-22 |
WO2009120498A1 (en) | 2009-10-01 |
US20090240335A1 (en) | 2009-09-24 |
CN101977558A (zh) | 2011-02-16 |
US8795365B2 (en) | 2014-08-05 |
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