JP2013516206A - 固定装置、椎間インプラント、および移植器具 - Google Patents
固定装置、椎間インプラント、および移植器具 Download PDFInfo
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- JP2013516206A JP2013516206A JP2012546508A JP2012546508A JP2013516206A JP 2013516206 A JP2013516206 A JP 2013516206A JP 2012546508 A JP2012546508 A JP 2012546508A JP 2012546508 A JP2012546508 A JP 2012546508A JP 2013516206 A JP2013516206 A JP 2013516206A
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- implant
- pawl
- fixture
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- 0 C1C2C1CC*C2 Chemical compound C1C2C1CC*C2 0.000 description 1
- WGCGDZHNLVYBTD-UHFFFAOYSA-N CCC1CC(C2)=C2C1 Chemical compound CCC1CC(C2)=C2C1 WGCGDZHNLVYBTD-UHFFFAOYSA-N 0.000 description 1
- WKHMEYMNHMHDCI-UHFFFAOYSA-N CCCCC1CC(C2)C2C1 Chemical compound CCCCC1CC(C2)C2C1 WKHMEYMNHMHDCI-UHFFFAOYSA-N 0.000 description 1
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Abstract
Description
固定装置(1)(または「固定具」)、および/または同一の、異なる、または補完的であってもよい複数の固定装置(1)を含む固定システム;
このような固定装置(1)またはシステムのうちの1つ以上を受容するように構成された椎間インプラント(2);および
椎骨の間にインプラント(2)を埋め込み、1つ以上の固定装置(1)または固定システムでインプラントを固着させるための器具(3、4)。
本願において説明される実施形態による固定装置(1)を提供するステップと;
本願において説明される実施形態による椎骨インプラント(2)を提供するステップと;
本願において説明される実施形態による移植器具(3、4)を提供するステップと;
移植器具(3、4)を用いて椎骨インプラント(2)を把持するステップと、を含んでもよい。
脊椎の隣り合う椎骨の間の椎間腔内に(または骨接合プレートの場合には脊椎の隣り合う椎骨上に)脊椎インプラント(2)を挿入するステップと;
(隣り合う椎骨のレベルにおいて)脊柱の軸に対して実質的に直交する進入路軸に沿って、固定装置(1)を提供するステップと;
移植器具(3、4)の嵌入具(4)を用いて、固定装置(1)がインプラント(2)の少なくとも一部を横断している状態で、移植器具(3、4)のガイドヘッド(30)を通じて、およびインプラント(2)内の通路(21)を通じて、固定装置(1)を挿入するステップと;
移植器具(3、4)の嵌入具(4)を用いて、隣り合う椎骨のうちの1つに固定装置(1)の少なくとも一部を埋め込み、インプラント(2)内に固定装置(1)を完全に挿入するステップと、をさらに含んでもよい。
技術的特徴および要素:
− リブ(11):椎骨内で固定具を安定化するように構成されてもよいが、さらに(インプラントの溝(211)を含む)インプラント内で固定具を安定化するように構成されてもよく、これはさらにインプラントを安定化するだろう。
− 直線通路内の湾曲固定具の場合の肥厚部および/または平坦面(20、110;110aおよび/または110b、111):インプラント内に固定具を安定化するのを支援するためにインプラント内に固定具の滑合を提供してもよく、したがって椎骨内で固定具を安定化してもよく、したがってインプラントをさらに安定化するだろう。
− 「垂直配向された」、すなわちプレート(10)の幅の方向に湾曲した固定具:椎骨内で固定具を安定化するように構成されてもよく、こうしてインプラントをさらに安定化するだろう。
技術的特徴および要素:
− 保持歯止め(14):椎骨内に埋め込まれた固定具によって、椎骨に対して押しつけられたままインプラントを保持してもよい。これは、椎骨上でインプラントを安定化するが、加えてインプラントおよび/または椎骨内で固定具をさらに安定化してもよい。
− 抜去歯止め(12):インプラント内で固定具を保持/維持してもよい。これは、インプラントおよび/または椎骨内で固定具を安定化し、椎骨間のインプラントをさらに安定化してもよい。
− 協働歯止め(18、19):インプラント内で2つの固定具の連結を可能にする。これはインプラントおよび/または椎骨内で固定具を安定化し、椎骨間でインプラントをさらに安定化してもよい。これらの協働歯止め(18、19)はさらに、必要な係止構造(およびそのサイズ)を最小化できるようにする。
技術的特徴および要素:
− 意図的な抜去のためにアクセス可能な保持歯止め(14):
インプラント内の補完的歯止め(214)は、固定具の保持歯止め(14)上を引っ張るために配置されてもよい
インプラント内の筐体(240)は、保持歯止め(14)へのアクセスを提供するために配置されてもよい
− 意図的な抜去のためにアクセス可能な協働歯止め(18、19):
固定具内の筐体(40)は、協働歯止め(18、19)のうちの少なくとも1つへのアクセスを提供するように構成されてもよい、
インプラント内の筐体(240)は、協働歯止め(18、19)のうちの少なくとも1つへのアクセスを提供するように構成されてもよい、
− 意図的な抜去のためにアクセス可能な抜去歯止め(12):
固定具内の筐体(40)は、抜去歯止め(12)へのアクセスを提供するように構成されてもよい、
インプラント内の筐体(240)は、抜去歯止め(12)へのアクセスを提供するように構成されてもよい、
固定具内の筐体(40)は、協働歯止め(18、19)および/または抜去歯止め(12)のうちの少なくとも1つへのアクセスを提供するように構成されてもよい、
インプラント内の筐体(240)は、協働歯止め(18、19)および/または抜去歯止め(12)のうちの少なくとも1つへのアクセスを提供するように構成されてもよい
技術的特徴および要素:
− 湾曲した剛性固定具のための湾曲通路は、通路を通じて固定具を案内するのに役立ち、固定具の最小クリアランスのために構成されてもよく、これは良好な安定性を保証するのに役立てるためのインプラント内の固定具の滑合を提供するだろう。
− 直線的剛性固定具のための直線通路は、通路を通じて固定具を案内するのに役立つように、および固定具の最小クリアランスを有するように構成されることが可能であり、これは良好な安定性を保証するのに役立てるためのインプラント内の固定具の滑合を提供するだろう。
− 湾曲した剛性固定具のための直接通路は、通路を通じて固定具を案内するのに役立ち、固定具の最小クリアランスのために構成されてもよく、これは良好な安定性を保証するのに役立てるためのインプラント内の固定具の滑合を提供するだろう。
− 直線的剛性固定具または相互間に角度を形成する複数の直線部分を備える固定具のための湾曲通路曲線:通路を通じて固定具を案内するのに役立ち、固定具の最小クリアランスのために構成されてもよく、これは良好な安定性を保証するのに役立てるためのインプラント内の固定具の滑合を提供するだろう。
Claims (48)
- 椎骨内に貫通するように設計された、前部と称される第一末端と、後部と称される第二末端との間に延在する長手軸(L)に沿って延伸する少なくとも1つの湾曲プレート(10)を含む本体を含み、少なくとも1つの椎体終板に貫通して、インプラントを保持する歯止めによってこの椎体終板にインプラント(2)を固着させるために、インプラント(2)の少なくとも一部を横断する通路(21)を通じて挿入されるように設計されている、椎骨内に椎間インプラント(2)を固定するための装置(1)であって、本体は、その面の少なくとも1つの少なくとも一部に少なくとも1つの長手方向リブ(11)を含み、前記リブ(11)はインプラント(2)の通路(21)内の少なくとも1つの溝(211)と協働するように設計されていることを特徴とする、装置(1)。
- 前記リブ(11)のレベルが本体の長手軸に沿って変化することを特徴とする、請求項1に記載の固定装置(1)。
- 前記リブ(11)のレベルが本体の長手軸に沿って変化することを特徴とする、請求項1および2に記載の固定装置(1)。
- 本体の湾曲プレート(10)が、本質的に椎間腔の平面内に長手軸(L)を有する一方で、脊柱の垂直軸に対しておよそ90°を形成する進入路の軸に沿って椎体終板内に固定装置(1)が埋め込まれるように作られた寸法および少なくとも1つの曲率半径を有する、円または楕円の少なくとも1つの弧を描くことを特徴とする、請求項1から3のいずれか一項に記載の固定装置(1)。
- 前部末端が、椎骨内への装置(1)の貫通を容易にする、少なくとも1つの面取り(15)または少なくとも1つの角取りを含むことを特徴とする、請求項1から4のいずれか一項に記載の固定装置(1)。
- 前部末端が、椎骨内への装置(1)の貫通を容易にする、少なくとも1つの刻み目(13)を含むことを特徴とする、請求項1から5のいずれか一項に記載の固定装置(1)。
- 本体には、一旦椎骨内に埋め込まれたら装置(1)の抜去に対抗するように配向された刻み目(16)が設けられていることを特徴とする、請求項1から6のいずれか一項に記載の固定装置(1)。
- 本体が、装置(1)が固定されるように設計されている椎骨に対してインプラント(2)を保持するために、装置(1)が固着されるように設計されたインプラント(2)上の少なくとも1つの歯止め面(214)と協働するように設計された、前部末端と本質的に対向して配向された少なくとも1つの歯止め面を含む、保持と称される少なくとも1つの歯止め(14)を含むことを特徴とする、請求項1から7のいずれか一項に記載の固定装置(1)。
- 保持歯止め(14)が、固定装置(1)の本体の少なくとも1面上に、少なくとも1つの突起ラグを含むことを特徴とする、請求項8に記載の固定装置(1)。
- 保持歯止め(14)が、固定装置(1)の本体の側面上に2つの突起ラグを含むことを特徴とする、請求項8に記載の固定装置(1)。
- 保持歯止め(14)が、後部末端のレベルで、リブ(11)に対して直角に突起する2つのラグを含むことを特徴とする、請求項8に記載の固定装置(1)。
- 本体が、後部末端に向かって配向され、固定装置(1)の抜去に対抗する抜去歯止めを形成する、少なくとも1つの可撓性ラグ(12)を含むことを特徴とする、請求項1から55に記載の固定装置(1)。
- プレート(10)の曲率がプレート(10)の深さにおいて配向されていることを特徴とする、請求項1から12のいずれか一項に記載の固定装置(1)。
- プレート(10)の曲率がプレート(10)の幅において配向されていることを特徴とする、請求項1から12のいずれか一項に記載の固定装置(1)。
- プレート(10)の後部末端付近に、インプラント(2)の通路(21)内での装置の遊びを制限する、プレート(10)の残部の厚みよりも大きい厚みを有する少なくとも1つの部分(20)を含むことを特徴とする、請求項1から14のいずれか一項に記載の固定装置(1)。
- 本体が、後部末端付近に、装置を抽出するためのツールを受容するために形成され、固定装置の抜去を可能にする、少なくとも1つの陥凹(40)を含むことを特徴とする、請求項1から15のいずれか一項に記載の固定装置(1)。
- 陥凹(40)が、ツールが前記陥凹内に直接貫通できるように、本体の後部末端上で開放していることを特徴とする、請求項1から16に記載の固定装置(1)。
- 可撓性ラグ(12)の歯止め末端が、インプラント(2)の外側に現れるチャネルを通じてインプラントの歯止め(212)から解放されることが可能であることを特徴とする、請求項12に記載の固定装置(1)。
- 一旦埋め込まれたら装置(1)を通じて骨成長を可能にするために、プレート(10)を横断する少なくとも1つの開口部(17)を含むことを特徴とする、請求項1から18のいずれか一項に記載の固定装置(1)。
- リブ(11)が、この刻み目がインプラント(2)の通路(21)の末端の歯止め面(220)で停止するように決定された距離だけ後部末端から離れて位置する刻み目(112)を含むことを特徴とする、請求項1から19のいずれか一項に記載の固定装置(1)。
- 請求項1から20による2つの装置(1)を含み、第一固定装置(1)が、前部末端と本質的に対向して配向された少なくとも1つの歯止め面を含む、協働と称される歯止め(18)を含み、第二固定装置(1)が、本質的に後部末端に対向する方向に配向された少なくとも1つの歯止め面を含む、協働と称される歯止め(19)を含み、これら2つの協働歯止め(18、19)は互いに協働するように作られていることを特徴とする、椎骨内に椎間インプラント(2)を固定するためのシステム。
- 第二固定装置(1)の歯止め(19)が、本質的に前部末端に対向するように配向された第二歯止め面を含み、第一装置(1)は、その後部歯止め末端が歯止め(19)の第二歯止め面(190)と接触して可撓性ラグ(12)を支持するのに役立つように位置決めされた可撓性ラグ(12)を含み、こうして一旦インプラント(2)内に収まったら、第二装置(1)を保持する第一装置の抜去を妨害することを特徴とする、請求項21に記載の固定システム(1)。
- 第一装置(1)の可撓性ラグ(12)の歯止め末端が、インプラントの外側に現れるチャネルを通じて、第二装置(1)の歯止め(19)の第二歯止め面から解放されることが可能であることを特徴とする、請求項1から22に記載の固定システム(1)。
- 後部と称されるその少なくとも一部が、その曲率に関わらず変形することなくこの剛性固定装置(1)の通過を許容するように、湾曲プレートを含む少なくとも1つの固定装置(1)を受容するのに適した寸法の少なくとも1つの直線通路(21)を含む、少なくとも1つの周囲壁(28)を含み、この通路(21)は、その間にインプラント(2)が埋め込まれるように設計されている椎骨の1つの椎体終板の方向に固定装置(1)を配向するように、本質的にインプラント(1)の平面(pane)内に挿入された、固定装置(1)の曲率に適合した直線および傾斜軌道に沿って、周囲から上面または下面に向かってインプラント(2)を横断している、椎間インプラント(2)であって、通路(21)は、請求項1から23のいずれか一項に記載の固定装置(1)の少なくとも1つのリブ(11)を受容するように設計された少なくとも1つの溝(211)を含むことを特徴とする、椎間インプラント(2)。
- 通路(21)が、インプラント(2)の外側の方向に配向され、固定装置(1)が通路(21)を通じて椎骨内に一旦固定されたらこの保持歯止め(14)がインプラント(2)を保持するように、固定装置(1)の少なくとも1つの保持歯止め(14)と協働するように設計された、少なくとも1つの歯止めを含む少なくとも1つの歯止め(214)を含むことを特徴とする、請求項1から24のいずれか一項に記載の椎間インプラント(2)。
- 通路(21)内に挿入された固定装置の前部末端と本質的に対向するように配向された少なくとも1つの歯止め面を含む少なくとも1つの抜去歯止め(212)を含み、この抜去歯止め(212)は、インプラント(2)からの固定装置(1)の抜去に対抗するために、固定装置(1)の少なくとも1つの可撓性ラグ(12)と協働することを特徴とする、請求項1から25のいずれか一項に記載の椎間インプラント(2)。
- 周囲壁(28)が、インプラント(2)を埋め込むための器具(3、4)の把持末端と協働するように設計された、少なくとも1つの締結手段(22、22a、22b、22c)を含むことを特徴とする、請求項1から26のいずれか一項に記載の椎間インプラント(2)。
- 周囲壁(28)が、その間にインプラント(2)が埋め込まれるように設計された椎骨の各々に固定装置(1)を固定するように、インプラント(2)の上面および下面のうちの1つに向かって各々配向された2つの通路(21)を含むことを特徴とする、請求項1から27のいずれか一項に記載の椎間インプラント(2)。
- 周囲壁(28)が、通路(21)を含むものの反対側の、いわゆる前部分に、椎骨間のインプラント(2)の挿入を容易にするように、少なくとも1つの角取り部分(27)を含むことを特徴とする、請求項1から28のいずれか一項に記載の椎間インプラント(2)。
- 椎骨間に椎間インプラント(2)を埋め込み、これら椎骨のうちの少なくとも1つに少なくとも1つの固定装置(1)を埋め込むための器具(3、4)であって、器具は、一方では固定装置(1)を押さえるのに適した形状およびサイズのヘッド(40)を含む少なくとも1つの嵌入具(4)を、他方ではインプラント(2)の把持と称される第一末端と、押さえと称される第二末端との間に延在する長手軸に沿って延伸する形状の少なくとも1つのガイド(3)を含み、把持末端は、インプラント(2)の少なくとも1つの締結手段(22)と協働するように設計された少なくとも1つの把持手段(321)を含み、ガイド(3)は、少なくとも部分的に嵌入具のヘッド(40)を受容するのに適した形状およびサイズのヘッド(30)であって、その間にインプラント(2)が埋め込まれるように設計された椎骨のうちの1つの椎体終板内に固定装置(1)を嵌入するために、請求項29から36のうちの1つに記載のインプラント(2)の通路(21)を通じてこの固定装置(1)を案内するように、請求項1から23による固定装置(1)の少なくとも1つの曲率半径と本質的に同一の少なくとも1つの曲率半径を有する少なくとも1つの案内面(31)を含み、固定装置(1)のリブ(11)の通過および/または案内を可能にするように作られている、ヘッド(30)を含むことを特徴とする、器具(3、4)。
- ヘッド(30)が、固定装置(1)のリブ(11)の通路のために作られた少なくとも1つの溝(3011)を含むことを特徴とする、請求項30に記載の器具(3、4)。
- ガイド(3)のヘッド(30)が、固定装置(1)を受容し、少なくとも部分的に嵌入具(4)のヘッド(40)を受容するのに適した形状およびサイズの空洞(300)を含み、案内面(31)は、本体(10)の両側で固定装置(1)の側面を案内するためにこの空洞(300)の片側に各々位置する少なくとも2つの湾曲溝(31)を含み、嵌入具(4)のヘッド(40)は、末端からこれら溝(31)の他方まで、空洞(300)内に貫通していることを特徴とする、請求項30および31のいずれか一項に記載の器具(3、4)。
- シャフト(321)が、シャフトがハンドル(33)によって作動されたときにインプラント(2)を固着させるために、陥凹(22、22a)の補完的なネジ切りと協働するネジ切り末端を含むことを特徴とする、請求項30から35のいずれか一項に記載の器具(3、4)。
- 締結手段(22)が陥凹(22、22a)を含むこと、および把持手段(321)が、インプラント(2)の陥凹(22、22a)に出入りするためにハンドル(33)によって作動されたときにガイド(3)の本体(32)内を摺動するシャフトの末端を含むことを特徴とする、請求項1から33のいずれか一項に記載の器具(3、4)。
- 締結手段(22)が、周囲壁(28)の側面に陥凹(22a)および溝(22b)を含み、把持手段(321)は、インプラント(2)の陥凹(22、22a)を出入りするためにハンドル(33)によって作動されたときにガイド(3)の本体(32)内を摺動するシャフトの1つの末端と、溝(22b)内に嵌合するように作られ、椎骨間でインプラント(2)を位置決めするためのレバーアームの役割を果たすラグ(3210)と、を含むことを特徴とする、請求項1から34のいずれか一項に記載の器具(3、4)。
- 溝(22b)が、器具によるインプラント(2)の把持を改善するように、ラグ(3210)のスタッド(3210b)を受容するように設計された陥凹(22c)を含むことを特徴とする、請求項35に記載の器具(3、4)。
- 固定装置(1)のリブ(11)の通路のために形成された前記溝(3011)が、ガイド(3)のヘッド(30)の空洞(300)の上部壁および/または下部壁の少なくとも一部に形成されることを特徴とする、請求項1から36のいずれか一項に記載の器具(3、4)。
- 椎骨内に貫通するように設計された、前部と称される第一末端と、後部と称される第二末端との間に延在する長手軸(L)に沿って延伸する少なくとも1つの直線プレート(10)を含む本体を含み、固定装置(1)は、少なくとも1つの椎体終板に貫通して、インプラントを保持する歯止めによってこの椎体終板にインプラント(2)を固着させるために、インプラント(2)の少なくとも一部を横断する通路(21)を通じて挿入されるように設計されている、椎骨内に椎間インプラント(2)を固定するための装置(1)であって、本体は、その面の少なくとも1つの少なくとも一部に少なくとも1つの長手方向リブ(11)を含み、前記リブ(11)はインプラント(2)の通路(21)内の少なくとも1つの溝(211)と協働するように設計されていることを特徴とする、装置(1)。
- 椎骨内に貫通するように設計された、前部と称される第一末端と、後部と称される第二末端との間に延在する長手軸(L)に沿って延伸する少なくとも1つのプレート(10)を含む本体を含み、固定装置(1)は、少なくとも1つの椎体終板に貫通して、インプラントを保持する歯止めによってこの椎体終板にインプラント(2)を固着させるために、インプラント(2)の少なくとも一部を横断する通路(21)を通じて挿入されるように設計されている、椎骨内に椎間インプラント(2)を固定するための装置(1)であって、本体は、インプラント(2)内の通路(21)の内壁との接触を提供し、インプラント(2)内で固定装置(1)を安定化するために配置された、少なくとも1つの肥厚部(20)および/または少なくとも1つの平坦面(110a、110b、111)を含むことを特徴とする、装置(1)。
- 椎骨内に貫通するように設計された、前部と称される第一末端と、後部と称される第二末端との間に延在する長手軸(L)に沿って延伸する少なくとも1つの湾曲プレート(10)を含む本体を含み、固定装置(1)は、少なくとも1つの椎体終板に貫通して、インプラントを保持する歯止めによってこの椎体終板にインプラント(2)を固着させるために、インプラント(2)の少なくとも一部を横断する通路(21)通じて挿入されるように設計されている、椎骨内にインプラント(2)を固定するための装置(1)であって、プレート(10)の曲率は、プレート(10)の幅に沿って配向されていることを特徴とする、装置(1)。
- 椎骨内に貫通するように設計された、前部と称される第一末端と、後部と称される第二末端との間に延在する長手軸(L)に沿って延伸する少なくとも1つのプレート(10)を含む本体を含み、固定装置(1)は、少なくとも1つの椎体終板に貫通して、インプラントを保持する歯止めによってこの椎体終板にインプラント(2)を固着させるために、インプラント(2)の少なくとも一部を横断する通路(21)通じて挿入されるように設計されている、椎骨内に椎間インプラント(2)を固定するための装置(1)であって、インプラントの補完的歯止め(212)との接触によってインプラント(2)からの固定装置(1)の抜去に対抗する少なくとも1つの抜去歯止め(12)を含み、固定装置(1)の抜去歯止めをその補完的歯止め(212)から解放するために配置されたリソース(40)を含むことを特徴とする、装置(1)。
- 後部と称されるその少なくとも一部が、少なくとも1つのプレートを含む少なくとも1つの固定装置(1)を受容するのに適した寸法の少なくとも1つの通路(21)を含む、少なくとも1つの周囲壁(28)を含み、この通路(21)は、その間にインプラント(2)が埋め込まれるように設計された椎骨のうちの1つの椎体終板の方向に固定装置(1)を配向するように、固定装置(1)に適合した軌道に沿って、周囲から上面または下面に向かってインプラント(2)を横断している、椎間インプラント(2)であって、インプラント(2)は、インプラント(2)からの固定装置(1)の抜去に対抗する抜去歯止め(12)を補完する少なくとも1つの歯止め(212)を含み、固定装置(1)の抜去歯止めをインプラント(2)内の補完的歯止め(212)から解放するために配置されたリソース(240)を含むことを特徴とする、椎間インプラント(2)。
- 後部と称されるその少なくとも一部が、少なくとも1つのプレートを含む少なくとも1つの固定装置(1)を受容するのに適した寸法の少なくとも1つの通路(21)を含む、少なくとも1つの周囲壁(28)を含み、この通路(21)は、その間にインプラント(2)が埋め込まれるように設計された椎骨のうちの1つの椎体終板の方向に固定装置(1)を配向するように、固定装置(1)に適合した軌道に沿って、周囲から上面または下面に向かってインプラント(2)を横断している、椎間インプラント(2)であって、インプラント(2)は、固定装置(1)の抜去のために配置されたリソース(214、240)を含むことを特徴とする、椎間インプラント(2)。
- 椎骨内に椎間インプラント(2)を固定するためのシステムであって、これは椎骨内にインプラントを固定するための2つの固定装置(1)を含み、各装置は、椎骨内に貫通するように設計された、前部と称される第一末端と、後部と称される第二末端との間に延在する長手軸(L)に沿って延伸する少なくとも2つのプレート(1°)を含む本体を有し、固定装置(1)は、インプラントを保持する歯止めによってこの椎体終板にインプラント(2)を固着させるために、少なくとも1つの椎体終板に貫通するために、インプラント(2)の少なくとも一部を横断する通路(21)を通じて挿入されるように設計されていることを特徴とし、第一固定装置(1)は、前部末端と本質的に対向して配向された少なくとも1つの歯止め面を含む、協働と称される歯止め(18)を含み、第二固定装置(1)は、後部末端と本質的に対向する方向に配向された少なくとも1つの歯止め面を含む、協働と称される歯止め(19)を含み、これら2つの協働歯止め(18、19)は互いに協動するように作られていることを特徴とする、システム。
- 第二固定装置(1)の歯止め(19)が、本質的に前部末端に対向して配向された第二歯止め面(190)を含み、第一装置(1)は、その後部歯止め末端が歯止め(19)の第二歯止め面(190)と接触して抜去歯止め(12)を支持するのに役立つように位置決めされた抜去歯止め(12)を含み、こうして一旦インプラント(2)内に収まったら、第二装置(1)を保持する第一装置の抜去を妨害することを特徴とする、請求項44に記載の固定システム。
- 固定装置(1)のうちの少なくとも1つが、第二歯止め面(190)から抜去歯止め(12)を解放するために配置されたリソース(40)を含むことを特徴とする、請求項45に記載の固定システム。
- 後部と称されるその少なくとも一部が、請求項44から46のいずれか一項に記載のシステムの少なくとも2つの固定装置(1)を受容するのに適した寸法の少なくとも2つの通路(21)を含む、少なくとも1つの周囲壁(28)を含み、これらの通路(21)は、その間にインプラント(2)が埋め込まれるように設計された椎骨のうちの1つの椎体終板の方向に固定装置(1)を配向するように、固定装置(1)に適合した軌道に沿って、周囲から上面または下面に向かってインプラント(2)を横断している、椎間インプラント(2)であって、インプラント(2)は、協働歯止め(18、19)を経由しての固定装置(1)の抜去のために配置されたリソース(214、240)を含むことを特徴とする、椎間インプラント(2)。
- 後部と称されるその少なくとも一部が、請求項44から46のいずれか一項に記載のシステムの少なくとも2つの固定装置(1)を受容するのに適した寸法の少なくとも2つの通路(21)を含む、少なくとも1つの周囲壁(28)を含み、これらの通路(21)は、その間にインプラント(2)が埋め込まれるように設計された椎骨のうちの1つの椎体終板の方向に固定装置(1)を配向するように、固定装置(1)に適合した軌道に沿って、周囲から上面または下面に向かってインプラント(2)を横断している、椎間インプラント(2)であって、インプラント(2)は、固定装置(1)の抜去歯止め(12)を解放するために配置されたリソース(240)を含むことを特徴とする、椎間インプラント(2)。
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