JP2014516264A - フィラメントの空間探索らせんを用いた組織修復 - Google Patents
フィラメントの空間探索らせんを用いた組織修復 Download PDFInfo
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- JP2014516264A JP2014516264A JP2014501062A JP2014501062A JP2014516264A JP 2014516264 A JP2014516264 A JP 2014516264A JP 2014501062 A JP2014501062 A JP 2014501062A JP 2014501062 A JP2014501062 A JP 2014501062A JP 2014516264 A JP2014516264 A JP 2014516264A
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- filament
- needle
- cannula
- disc
- deployment device
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Neurology (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Urology & Nephrology (AREA)
- Pathology (AREA)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
Description
下部腰椎L5−S1椎間板100AおよびL4−5椎間板100Bは、図44に示すように一対の腸骨稜140によって遮蔽されている。真っ直ぐな穿刺針102は、図45に示すように、斜めに、腸骨稜140の上方に入るが、椎間板100の髄核128内にシャント126を送達することは困難または不可能である。
脊柱に関する多くの外科的介入とは異なり、椎間板シャント126の利益として、(1)背骨の可動性の維持、(2)組織の非除去、(3)抽出による可逆性、(4)微小浸潤、(5)外来患者への手術、(6)認可されたインプラント材料、(7)1椎間板あたり15分間、(8)長期間継続し、害がない、(9)切開しない、(10)必要に応じて、薬物、保存療法または外科的介入と適合する、(11)疼痛緩和を促進するために、必要に応じて、シャントを薬物でコーティングできること、が挙げられる。
100A L5−S1椎間板
100B L4−5椎間板
100C L3−4椎間板
101 針/ニードル
102 穿刺針
103 ガイドワイヤまたは管
104 フィラメントのストランド
105 終板
106A 上部拡散域
106B 下部拡散域
107 毛細血管
108 石灰化層
109 血管蕾
110 カニューレのウィンドウ
111 フィラメントニードルのフィラメント把持部
112 エクステンションバー
113 スナッグ点間のインデント
114 環状剥離
115 骨端
116 拡張器のルーメン
118 感覚神経
119 硬膜上腔
120 把持部間のインデント
121 索裂
123 脊椎
124 スポンジ状シャントの細孔
126 フィラメント、シャント、または椎間板シャント
126A フィラメントのU字形部分または遠位部
126B メインシャントの第2の近位部
126C フィラメントの第1の近位部
127 フィラメントのカバーまたは被覆
128 髄核
129 面関節
130 フィラメントニードルハンドル
131 栄養素、酸素およびpH緩衝溶質
132 カニューレハンドル
133 横突起
134 棘突起
135 椎弓板
140 腸骨または腸骨稜
142 上関節突起
143 下関節突起
152 ボビン
159 椎体
160 生合成産物または分子
162 乳酸
163 造影剤
184 組織内の孔または空隙
193 筋肉
194 脊髄神経根
195 後縦靱帯
220 拡張器
230 カニューレ
231 カニューレのスナッグ点、遠位端またはエッジまたは辺縁
268 カニューレのルーメン
269 フィラメントニードルのルーメン
276 シリンジ
277 細胞
278 椎弓根
378 環帯または環状層
460 細い穿刺針
462 アンカーまたはトグル
463 結び目
492 カニューレのルーメン内に至るじょうご
493 フィラメントニードル上のマーカー
494 ラッチの柔軟性ホルダ
495 ラッチ
496 ラッチのスロープまたは傾斜した表面
497 ボビン・ホルダ
498 カニューレハンドルの遠位突起
499 カニューレハンドルの近位突起
500 フィラメントニードルハンドルの遠位突起
501 フィラメントニードルハンドルの近位突起
502 ニードルハンドルの隆起紋様(Friction Reidges)
504 Kambinの三角形(椎間板への安全な侵入)
505 皮膚
516 尿道
517 尿道腔
518 膀胱
519 膀胱頸部
520 膣
521 恥骨
522 子宮
523 直腸
524 尿道カニューレの遠心壁
525 鉗子
526 フィラメント・アドバンサ
527 フィラメント・アドバンサの柄
528 フィラメント・アドバンサの返しまたはねじ山
529 拡張器のコーンヘッド
530 取り外し可能なルアーロックまたは拡張器・ハンドル
531 シリンジのルアーロック
532 尿道平滑筋
533 尿道腔粘膜
Claims (18)
- 選択可能量のフィラメントを組織内に埋め込むための展開装置であって、前記展開装置が、
その遠位端が埋め込み位置内に設置されるように誘導することができるカニューレ、
近位部および遠位部を有するフィラメント、および
近位端および遠位端を備えたフィラメントニードル
を備え、
前記フィラメントの遠位部が前記フィラメントニードルの遠位端から伸延し、
前記フィラメントニードルの遠位端と前記フィラメントの遠位部が前記カニューレ内に完全に設置可能であり、
前記フィラメントニードルが回転能力を有し、それによって、前記フィラメントの遠位部が捻じられて前記フィラメントニードルの遠位端より遠位に設置された捻じれた遠位部を形成し、
前記フィラメントの捻じれた遠位部を埋め込み位置に充填するために、前記フィラメントニードルを進行および後退させることができる、
展開装置。 - 選択可能量のフィラメントを組織内に埋め込むための展開装置であって、前記展開装置が、
埋め込み位置内に到達し、穿刺することができるニードル、
前記ニードル内に挿入可能な遠位部を備えたガイドワイヤ、
前記ガイドワイヤ上をスライドするような寸法に作製されたルーメンを備えた拡張器、
前記拡張器に沿ってスライドするような寸法に作製されたルーメンを備えた、遠位端を備えたカニューレ、
近位部および遠位部を備えたフィラメント、および
近位端および遠位端を備えたフィラメントニードル
を備え、
前記フィラメントの遠位部が前記フィラメントニードルの遠位端から伸延し、
前記フィラメントニードルの遠位端と前記フィラメントの遠位部が前記カニューレ内に完全に設置可能であり、
前記フィラメントニードルが回転能力を有し、それによって前記フィラメントの遠位部が捻じれて前記フィラメントニードルの遠位端より遠位に設置された捻じれた遠位部を形成し、
前記埋め込み位置内に前記フィラメントの捻じれた遠位部を充填するために、前記フィラメントニードルを進行および後退させることができる、
展開装置。 - 前記フィラメントニードルが2回以上進行および後退させることができ、それによって、前記展開装置が埋め込み位置において前記フィラメントの複数の捻じれた遠位部の充填を可能にする、請求項1または2に記載の展開装置。
- アドバンサをさらに備え、
前記アドバンサが、前記フィラメントニードルの少なくとも一部と係合するように構成され、作動されたときに、前記フィラメントの遠位部を前記フィラメントニードルの遠位端から出るように動かす
ことを特徴とする請求項1または2に記載の展開装置。 - 前記アドバンサが、前記フィラメントとともに前記フィラメントニードル内に設置可能な、らせん状にねじ切りされたオーガーであることを特徴とする請求項4記載の展開装置。
- 前記アドバンサが、その長さに沿って設置された1つ以上の返しを有する伸延体であることを特徴とする請求項4記載の展開装置。
- 前記カニューレの遠位端が、少なくとも1つのフィラメント引っ掛け部を有することを特徴とする請求項1または2記載の展開装置。
- 前記少なくとも1つのフィラメント引っ掛け部が鋭い先端の形態をとることを特徴とする請求項7記載の展開装置。
- 前記少なくとも1つのフィラメント引っ掛け部がバネ付勢したアームの形態をとることを特徴とする請求項7記載の展開装置。
- 前記フィラメントニードルの遠位端がフィラメント把持部を備えることを特徴とする請求項1または2記載の展開装置。
- 前記フィラメント把持部が、その遠位において鋭い先端の形態をとることを特徴とする請求項10記載の展開装置。
- 前記フィラメント把持部が、前記フィラメントニードルのルーメンにおいてクロスバーの形態をとることを特徴とする請求項10記載の展開装置。
- 前記フィラメント把持部が、前記フィラメントニードルのルーメンを長手方向に分断する横断面の形態をとることを特徴とする請求項10記載の展開装置。
- 前記フィラメント把持部が、前記フィラメントニードルのルーメンにおいてクロススタブの形態をとることを特徴とする請求項10記載の展開装置。
- 前記フィラメント把持部が、前記フィラメントニードルのルーメン内へと長手方向に伸延するクロススタブの形態をとることを特徴とする請求項10記載の展開装置。
- 前記カニューレが近位端を備え、前記近位端がじょうごをさらに備えることを特徴とする請求項1または2記載の展開装置。
- 前記カニューレの近位端が、前記フィラメントニードルの近位端と係合するラッチをさらに備えることを特徴とする請求項16記載の展開装置。
- 前記フィラメントニードルの近位端がボビンを備え、
前記フィラメントの近位部が前記ボビン上に巻き取られることを特徴とする請求項1または2記載の展開装置。
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US10342663B2 (en) | 2016-12-19 | 2019-07-09 | Perumala Corporation | Disc and vertebral defect packing tape |
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SG192842A1 (en) | 2013-09-30 |
KR20130137224A (ko) | 2013-12-16 |
EP2688499B1 (en) | 2017-09-27 |
WO2012128829A1 (en) | 2012-09-27 |
CN103607966B (zh) | 2016-03-16 |
CN103607966A (zh) | 2014-02-26 |
US9138254B2 (en) | 2015-09-22 |
KR101570480B1 (ko) | 2015-11-19 |
MX2013010705A (es) | 2014-02-28 |
US20130289599A1 (en) | 2013-10-31 |
IL228037A (en) | 2017-12-31 |
BR112013024208A2 (pt) | 2017-06-27 |
CA2829882C (en) | 2020-03-31 |
MX339154B (es) | 2016-05-13 |
US9980821B2 (en) | 2018-05-29 |
RU2607322C2 (ru) | 2017-01-10 |
EP2688499A1 (en) | 2014-01-29 |
MY162928A (en) | 2017-07-31 |
CA2829882A1 (en) | 2012-09-27 |
US20160058566A1 (en) | 2016-03-03 |
AU2012231726A1 (en) | 2013-09-12 |
ES2651640T3 (es) | 2018-01-29 |
RU2013147185A (ru) | 2015-04-27 |
JP6071994B2 (ja) | 2017-02-01 |
IL228037A0 (en) | 2013-09-30 |
NZ614426A (en) | 2015-12-24 |
AU2012231726B2 (en) | 2016-09-22 |
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