JP2015533615A - 椎体間干渉インプラント及び器具 - Google Patents
椎体間干渉インプラント及び器具 Download PDFInfo
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- JP2015533615A JP2015533615A JP2015541934A JP2015541934A JP2015533615A JP 2015533615 A JP2015533615 A JP 2015533615A JP 2015541934 A JP2015541934 A JP 2015541934A JP 2015541934 A JP2015541934 A JP 2015541934A JP 2015533615 A JP2015533615 A JP 2015533615A
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- implant
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- head
- locking
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- LMDZZSNKRYUNRK-ADGZMHETSA-N CCC(C1[C@@H](C)[C@H]1C)C([C@@H]12)(C1C=C)N[C@@H]2[IH]C#CC Chemical compound CCC(C1[C@@H](C)[C@H]1C)C([C@@H]12)(C1C=C)N[C@@H]2[IH]C#CC LMDZZSNKRYUNRK-ADGZMHETSA-N 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- 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
- A61B17/7055—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant connected to sacrum, pelvis or skull
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- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
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- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
- A61F2002/30995—Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for sacro-iliac joints
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2002/4625—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
- A61F2002/4627—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4677—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using a guide wire
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- Physical Education & Sports Medicine (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
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- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
Description
本出願は、2012年11月12日出願の米国仮特許出願第61/725,179号に基づく優先権を主張するものであり、当該出願の開示内容を恰もその全体が本明細書に記載されたものと同様にして本明細書に参照によって援用するものである。
(1) 仙骨と腸骨との間に画定される仙腸関節に、挿入方向に沿って挿入されるように構成されたインプラントであって、前記インプラントが、
近位端と、前記挿入方向に沿って前記近位端から離間した遠位端と、を有し、前記インプラントが前記仙腸関節に挿入されると前記腸骨に当接するような寸法と構成である腸骨係合面と、前記インプラントが前記仙腸関節に挿入されると前記仙骨に当接するような寸法と構成である仙骨係合面と、を画定する、インプラント本体であって、前記腸骨係合面と前記仙骨係合面のうちの少なくとも一方が、前記近位端から前記遠位端の方向に沿って延びるにしたがって、前記腸骨係合面と前記仙骨係合面のうちの他方に向かって収束する、インプラント本体と、
前記インプラント本体の前記近位端から延在する頭部であって、頭部本体と、前記頭部本体を貫通して第1の中央軸に沿って延在する第1の骨固定要素受け入れ開口と、を含み、前記インプラント本体が前記仙腸関節内に受け入れられると、前記第1の骨固定要素受け入れ開口が前記第1の中央軸に沿って骨固定要素を受け入れるように構成され、前記骨固定要素を前記仙骨又は前記腸骨のうちの1つと整列させるようになっている、頭部と、を備えるインプラント。
(2) 前記頭部が、前記頭部本体を貫通して第2の中央軸に沿って延在する第2の骨固定要素受け入れ開口を更に含み、前記インプラント本体が前記仙腸関節内に受け入れられると、前記第2の骨固定要素受け入れ開口が前記第2の中央軸に沿って第2の骨固定要素を受け入れるように構成され、前記第2の骨固定要素を前記仙骨又は前記腸骨のうちの1つと整列させるようになっており、前記第1及び第2の中央軸が、前記インプラント本体の前記近位端から前記遠位端の方向に沿って延びるにしたがって分岐する、実施態様1に記載のインプラント。
(3) 前記頭部が、前記頭部本体を貫通して第3及び第4の中央軸に沿って延在する第3及び第4の骨固定要素受け入れ開口を更に含み、前記インプラント本体が前記仙腸関節内に受け入れられると、前記第3及び第4の骨固定要素受け入れ開口がそれぞれ前記第3及び第4の軸に沿って第3及び第4の骨固定要素を受け入れるように構成され、前記第3及び第4の骨固定要素を前記仙骨又は前記腸骨のうちの1つと整列させるようになっている、実施態様2に記載のインプラント。
(4) 前記第3の骨固定要素受け入れ開口が、第1の方向に沿って前記第1の骨固定要素受け入れ開口と整列し、前記第4の骨固定要素受け入れ開口が、前記第1の方向に平行な第2の方向に沿って、前記第2の骨固定要素受け入れ開口と整列する、実施態様3に記載のインプラント。
(5) 前記頭部が、前記頭部本体を貫通して前記挿入方向に沿って延在するガイドワイヤチャネルを更に含む、実施態様1〜4のいずれかに記載のインプラント。
(7) 前記インプラント本体が、前記インプラント本体を貫通して前記挿入方向に沿って延在するガイドワイヤ受け入れチャネルを含み、前記頭部の前記ガイドワイヤチャネルが前記インプラント本体の前記ガイドワイヤチャネルと同軸となるようになっている、実施態様5又は6に記載のインプラント。
(8) 前記インプラント本体が、第1の本体部分と、前記挿入方向に対して直交する方向に沿って前記第1の本体部分から離れた第2の本体部分と、を含み、前記インプラント本体の前記ガイドワイヤチャネルを画定するギャップが、前記第1の本体部分と前記第2の本体部分との間に画定されるようになっている、実施態様5〜7のいずれかに記載のインプラント。
(9) 前記頭部が、第1のロッキング中央軸に沿って前記頭部本体内に延在する第1のロッキングチャネルと、前記第1のロッキング中央軸に対して角度オフセットした第2のロッキング中央軸に沿って前記頭部本体内に延在する第2のロッキングチャネルと、を更に含む、実施態様1〜8のいずれかに記載のインプラント。
(10) 前記頭部が、前記挿入方向に実質的に直交する方向に沿って、前記頭部を貫通して延在するロッド受け入れチャネルを画定する、実施態様1〜8のいずれかに記載のインプラント。
(12) 前記第1の脚と前記第2の脚が離間して、ロッキングキャップを受け入れるように構成されたロッキングキャップチャネルを画定し、前記ロッキングキャップが前記ロッキングキャップチャネル内に受け入れられると、前記第1及び第2の脚が前記ロッキングキャップの雄ねじと結合するように構成された雌ねじをそれぞれ画定する、実施態様11に記載のインプラント。
(13) 前記頭部が前記頭部本体から延在する第3の脚と第4の脚を更に含み、前記第1、第2、第3及び第4の脚が互いに離間して前記ロッド受け入れチャネルと前記ロッキングキャップチャネルを画定する、実施態様11又は12に記載のインプラント。
(14) システムであって、
実施態様9に記載のインプラントと、
前記インプラントを前記仙腸関節に挿入するように構成された挿入器具であって、
近位端と前記挿入方向に沿って前記近位端から離間した遠位端とを画定するガイド本体であって、中央チャネル軸に沿って前記ガイド本体の少なくとも一部を貫通して延在し、前記遠位端の外に延びるチャネルを有する、ガイド本体と、
前記ガイド本体の前記チャネル内でロック解除位置とロック位置との間で可動であり、前記ロック解除位置にある時より前記ロック位置にある時に前記遠位端からより遠くへ延びる第1のロッキング部材と、
前記中央チャネル軸に対して角度オフセットした第2の部材中央軸に沿って前記ガイド本体の前記遠位端から延在し、前記仙腸関節インプラントの前記第2のロッキングチャネルによって受け入れられるように構成された第2のロッキング部材と、を含む、挿入器具と、を備え、
前記第2のロッキング部材が前記仙腸関節インプラントの前記第2のロッキングチャネルに挿入されると、前記ガイド本体の前記チャネルが、前記仙腸関節インプラントの前記第1のロッキングチャネルに対して同軸となって位置決めされるように構成され、前記第1のロッキング部材の前記ロック解除位置から前記ロック位置への移動によって、前記第1のロッキング部材が前記第1のロッキングチャネル内へ挿入されて前記仙腸関節インプラントが前記挿入器具と連結されるようになっている、システム。
(15) システムであって、
実施態様10〜13のいずれかに記載され、かつ第1の仙腸関節に挿入されるように構成された、第1のインプラントと、
実施態様10〜13のいずれかに記載され、かつ第2の仙腸関節に挿入されるように構成された、第2のインプラントと、
ブリッジとして構成され、前記第1のインプラントの前記ロッド受け入れチャネルによって受け入れられるように構成された第1の側と、前記第2のインプラントの前記ロッド受け入れチャネルによって受け入れられるように構成された第2の側と、を有するロッドと、を備えるシステム。
Claims (15)
- 仙骨と腸骨との間に画定される仙腸関節に、挿入方向に沿って挿入されるように構成されたインプラントであって、前記インプラントが、
近位端と、前記挿入方向に沿って前記近位端から離間した遠位端と、を有し、前記インプラントが前記仙腸関節に挿入されると前記腸骨に当接するような寸法と構成である腸骨係合面と、前記インプラントが前記仙腸関節に挿入されると前記仙骨に当接するような寸法と構成である仙骨係合面と、を画定する、インプラント本体であって、前記腸骨係合面と前記仙骨係合面のうちの少なくとも一方が、前記近位端から前記遠位端の方向に沿って延びるにしたがって、前記腸骨係合面と前記仙骨係合面のうちの他方に向かって収束する、インプラント本体と、
前記インプラント本体の前記近位端から延在する頭部であって、頭部本体と、前記頭部本体を貫通して第1の中央軸に沿って延在する第1の骨固定要素受け入れ開口と、を含み、前記インプラント本体が前記仙腸関節内に受け入れられると、前記第1の骨固定要素受け入れ開口が前記第1の中央軸に沿って骨固定要素を受け入れるように構成され、前記骨固定要素を前記仙骨又は前記腸骨のうちの1つと整列させるようになっている、頭部と、を備えるインプラント。 - 前記頭部が、前記頭部本体を貫通して第2の中央軸に沿って延在する第2の骨固定要素受け入れ開口を更に含み、前記インプラント本体が前記仙腸関節内に受け入れられると、前記第2の骨固定要素受け入れ開口が前記第2の中央軸に沿って第2の骨固定要素を受け入れるように構成され、前記第2の骨固定要素を前記仙骨又は前記腸骨のうちの1つと整列させるようになっており、前記第1及び第2の中央軸が、前記インプラント本体の前記近位端から前記遠位端の方向に沿って延びるにしたがって分岐する、請求項1に記載のインプラント。
- 前記頭部が、前記頭部本体を貫通して第3及び第4の中央軸に沿って延在する第3及び第4の骨固定要素受け入れ開口を更に含み、前記インプラント本体が前記仙腸関節内に受け入れられると、前記第3及び第4の骨固定要素受け入れ開口がそれぞれ前記第3及び第4の軸に沿って第3及び第4の骨固定要素を受け入れるように構成され、前記第3及び第4の骨固定要素を前記仙骨又は前記腸骨のうちの1つと整列させるようになっている、請求項2に記載のインプラント。
- 前記第3の骨固定要素受け入れ開口が、第1の方向に沿って前記第1の骨固定要素受け入れ開口と整列し、前記第4の骨固定要素受け入れ開口が、前記第1の方向に平行な第2の方向に沿って、前記第2の骨固定要素受け入れ開口と整列する、請求項3に記載のインプラント。
- 前記頭部が、前記頭部本体を貫通して前記挿入方向に沿って延在するガイドワイヤチャネルを更に含む、請求項1〜4のいずれか一項に記載のインプラント。
- 前記頭部が、前記頭部本体を貫通して前記第1の骨固定要素受け入れ開口と前記第2の骨固定要素受け入れ開口との間に延在するガイドワイヤチャネルを更に含む、請求項2〜4のいずれか一項に記載のインプラント。
- 前記インプラント本体が、前記インプラント本体を貫通して前記挿入方向に沿って延在するガイドワイヤ受け入れチャネルを含み、前記頭部の前記ガイドワイヤチャネルが前記インプラント本体の前記ガイドワイヤチャネルと同軸となるようになっている、請求項5又は6に記載のインプラント。
- 前記インプラント本体が、第1の本体部分と、前記挿入方向に対して直交する方向に沿って前記第1の本体部分から離れた第2の本体部分と、を含み、前記インプラント本体の前記ガイドワイヤチャネルを画定するギャップが、前記第1の本体部分と前記第2の本体部分との間に画定されるようになっている、請求項5〜7のいずれか一項に記載のインプラント。
- 前記頭部が、第1のロッキング中央軸に沿って前記頭部本体内に延在する第1のロッキングチャネルと、前記第1のロッキング中央軸に対して角度オフセットした第2のロッキング中央軸に沿って前記頭部本体内に延在する第2のロッキングチャネルと、を更に含む、請求項1〜8のいずれか一項に記載のインプラント。
- 前記頭部が、前記挿入方向に実質的に直交する方向に沿って、前記頭部を貫通して延在するロッド受け入れチャネルを画定する、請求項1〜8のいずれか一項に記載のインプラント。
- 前記頭部が、前記頭部本体から延在する、少なくとも第1の脚と第2の脚を含み、前記第1の脚と前記第2の脚が互いに離間して前記ロッド受け入れチャネルを画定するようになっている、請求項10に記載のインプラント。
- 前記第1の脚と前記第2の脚が離間して、ロッキングキャップを受け入れるように構成されたロッキングキャップチャネルを画定し、前記ロッキングキャップが前記ロッキングキャップチャネル内に受け入れられると、前記第1及び第2の脚が前記ロッキングキャップの雄ねじと結合するように構成された雌ねじをそれぞれ画定する、請求項11に記載のインプラント。
- 前記頭部が前記頭部本体から延在する第3の脚と第4の脚を更に含み、前記第1、第2、第3及び第4の脚が互いに離間して前記ロッド受け入れチャネルと前記ロッキングキャップチャネルを画定する、請求項11又は12に記載のインプラント。
- システムであって、
請求項9に記載のインプラントと、
前記インプラントを前記仙腸関節に挿入するように構成された挿入器具であって、
近位端と前記挿入方向に沿って前記近位端から離間した遠位端とを画定するガイド本体であって、中央チャネル軸に沿って前記ガイド本体の少なくとも一部を貫通して延在し、前記遠位端の外に延びるチャネルを有する、ガイド本体と、
前記ガイド本体の前記チャネル内でロック解除位置とロック位置との間で可動であり、前記ロック解除位置にある時より前記ロック位置にある時に前記遠位端からより遠くへ延びる第1のロッキング部材と、
前記中央チャネル軸に対して角度オフセットした第2の部材中央軸に沿って前記ガイド本体の前記遠位端から延在し、前記仙腸関節インプラントの前記第2のロッキングチャネルによって受け入れられるように構成された第2のロッキング部材と、を含む、挿入器具と、を備え、
前記第2のロッキング部材が前記仙腸関節インプラントの前記第2のロッキングチャネルに挿入されると、前記ガイド本体の前記チャネルが、前記仙腸関節インプラントの前記第1のロッキングチャネルに対して同軸となって位置決めされるように構成され、前記第1のロッキング部材の前記ロック解除位置から前記ロック位置への移動によって、前記第1のロッキング部材が前記第1のロッキングチャネル内へ挿入されて前記仙腸関節インプラントが前記挿入器具と連結されるようになっている、システム。 - システムであって、
請求項10〜13のいずれか一項に記載され、かつ第1の仙腸関節に挿入されるように構成された、第1のインプラントと、
請求項10〜13のいずれか一項に記載され、かつ第2の仙腸関節に挿入されるように構成された、第2のインプラントと、
ブリッジとして構成され、前記第1のインプラントの前記ロッド受け入れチャネルによって受け入れられるように構成された第1の側と、前記第2のインプラントの前記ロッド受け入れチャネルによって受け入れられるように構成された第2の側と、を有するロッドと、を備えるシステム。
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CN104968302B (zh) | 2017-04-12 |
US10278742B2 (en) | 2019-05-07 |
WO2014074853A1 (en) | 2014-05-15 |
CN104968302A (zh) | 2015-10-07 |
US20140135927A1 (en) | 2014-05-15 |
AU2013342208A1 (en) | 2015-06-11 |
JP6215339B2 (ja) | 2017-10-18 |
EP2916777A1 (en) | 2015-09-16 |
AU2013342208B2 (en) | 2018-05-17 |
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