JP2017517334A - 人工脊椎円板置換及びその方法 - Google Patents
人工脊椎円板置換及びその方法 Download PDFInfo
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- JP2017517334A JP2017517334A JP2016572285A JP2016572285A JP2017517334A JP 2017517334 A JP2017517334 A JP 2017517334A JP 2016572285 A JP2016572285 A JP 2016572285A JP 2016572285 A JP2016572285 A JP 2016572285A JP 2017517334 A JP2017517334 A JP 2017517334A
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- end plate
- disc
- endplate
- keel
- intervertebral
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- A—HUMAN NECESSITIES
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- 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
- 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
- A61F2002/4629—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 connected to the endoprosthesis or implant via a threaded connection
-
- 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
- A61F2002/4681—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor by applying mechanical shocks, e.g. by hammering
-
- 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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
- A61F2310/00407—Coating made of titanium or of Ti-based alloys
-
- 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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
- A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
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Abstract
Description
本出願は、2004年7月30日提出の米国第10/909,210号、現米国第7,641,666号、2004年4月20日提出の米国第10/827,642号、現米国第7,621,956号、及び2003年7月31日提出の米国仮出願第60/491,271号の優先権を主張する、2005年10月11日提出の米国第11/246,149号、現米国第8,167,948号の一部継続である、2005年12月28日提出の米国第11/318,438号、現米国第7,713,304号の一部継続である、2006年3月3日提出の米国第11/366,390号、現米国第7,811,329号の継続である、2013年5月8日提出の米国第13/889,876号の一部継続である。これらの参照のそれぞれは、参照によりその全体が本明細書に組み込まれる。
[技術分野]
[背景技術]
[発明の概要]
[図面の簡単な説明]
[図2]本発明の人工円板デザインの下終板の例証である。
[図3]本発明の人工円板デザインの上終板の例証である。
[図4]本発明の人工円板デザインの実施形態の例証である。
[図5]本発明の人工円板デザインの実施形態の例証である。
[図6]本発明の人工円板デザインのキールの例証である。
[図7]本発明の人工円板デザインのキールの例証である。
[図8]本発明の別の実施形態の斜視図である。
[図9]図8の実施形態の終板の斜視図である。
[図10]図8の実施形態の終板の斜視図である。
[図11]図8の実施形態の終板の斜視図である。
[図12]図8の実施形態の終板の斜視図である。
[図13]本発明の実施形態の斜視図である。
[図14]図13の実施形態の分解立体図である。
[図15]図13の実施形態の断面図である。
[図16]本発明の実施形態の斜視図である。
[図17]図16の実施形態の分解立体図である。
[図18]図16の実施形態の断面図である。
[図19]本発明の実施形態の斜視図である。
[図20]図19の実施形態の分解立体図である。
[図21]図20の実施形態の終板の斜視図である。
[図22]図20の実施形態の断面図である。
[図23〜24]代表的な椎体の斜視図である。
[図25]本発明の実施形態に従うセパレータの斜視図である。
[図26]本発明の実施形態に従うセパレータの斜視図である。
[図27及び27A]本発明の実施形態に従うトライアルの斜視図である。
[図28]本発明の実施形態に従うトライアルヘッドの斜視図である。
[図29]本発明の実施形態に従うトライアルの斜視図である。
[図30]本発明の実施形態に従うトライアルの斜視図である。
[図31〜32]本発明の実施形態に従うトライアル及びチゼルの斜視図である。
[図33〜34]本発明の実施形態に従うインプラント及びインプラントホルダの斜視図ある。
[図35〜36]本発明の実施形態に従うインプラントホルダの断面図である。
[図37〜38]本発明の実施形態に従うインプラントの斜視図である。
[図39a〜c]2つの終板の間にコア部材を含む三構成要素のインプラントの図を示す。
[図40〜43]最適化された迅速接合及びねじ式保持機構を含むインプラントの代替図を提供する。
[図44〜46]移植後に一次及び二次安定性を提供するように設計されたピンまたはスパイクを含むインプラントの代替図を示す。
[発明を実施するための形態]
Claims (18)
- 椎間人工円板であって、
第1の終板であって、第1の椎体と実質的に係合するように構成される第1の面と、前記第1の終板の相対的運動を可能にするように構成される関節接合面を含む第2の面とを有する、第1の終板と、
第2の終板であって、第2の椎体と実質的に係合するように構成される第1の面と、前記第2の終板の相対的運動を可能にするように構成される関節接合面を含む第2の面とを有する、第2の終板と、を備え、
前記第1の終板の前記第1の面が、前記第1の椎体内の溝と係合するように構成される第1のキールを有し、前記第1のキールは、第1の開口部が通って延在する第1の背向面を有し、前記第1の開口部は、第1の縦軸を有する第1の穿孔と、前記第1の縦軸に対して斜めに延在する第1の湾曲状切り欠きとを含み、
前記第2の終板の前記第1の面が、前記第2の椎体内の溝と係合するように構成される第2のキールを有し、前記第2のキールは、第2の開口部が通って延在する第2の背向面を有し、前記第2の開口部は、第2の縦軸を有する第2の穿孔と、前記第2の縦軸から斜めに延在する第2の湾曲状切り欠きとを含み、
前記第1及び第2の湾曲状切り欠きが、第1の保持機構を受容するように構成され、前記第1及び第2の穿孔が、第2の保持機構を受容するように構成され、
前記第1及び第2のキールのうちの少なくとも一方が、前記キールの遠位縁から前記キールの基部へ下方にある長さだけ延在する少なくとも1つのスロットを有し、
前記第1及び第2のキールのうちの前記少なくとも一方が、前記キールを位置合わせして前記第1及び第2の椎体内の前記溝に挿入するための面取り部を含む前縁を含む、椎間人工円板。 - 前記第1の保持機構が、前記第1の湾曲状切り欠きを係合するように構成される第1のアームと、前記第2の湾曲状切り欠きを係合するように構成される第2のアームとを有する迅速接合ホルダである、請求項1に記載の椎間人工円板。
- 前記第1及び第2の穿孔がねじ式である、請求項1に記載の椎間人工円板。
- 前記第2の保持機構がねじ式ホルダである、請求項3に記載の椎間人工円板。
- 前記第1及び第2の終板の間に少なくとも部分的に配置されるコア要素をさらに備える、請求項1に記載の椎間人工円板。
- 前記コア要素が、前記第1の終板の前記第2の面と連通し、かつそれに実質的に対応する第1の起伏面と、前記第2の終板の前記第2の面と実質的に連通し、かつそれに実質的に対応する第2の起伏面とを備える、請求項1に記載の椎間人工円板。
- 前記第2の終板の前記関節接合面が、実質的に矢状面で前記コア要素に対する前記第2の終板の回旋を許容する、請求項6に記載の椎間人工円板。
- 前記第1の終板の前記第2の面の前記関節接合面が、実質的にすべての平面で前記コア要素に対する前記第1の終板の回旋を許容する、請求項6に記載の椎間人工円板。
- 前記第1及び第2の終板が、前記第1及び第2の終板が互いに分離することを防ぐために制約される、請求項1に記載の椎間人工円板。
- 椎間人工円板であって、
第1の終板であって、第1の椎体と実質的に係合するように構成される第1の面と、前記第1の終板の相対的運動を可能にするように構成される関節接合面を含む第2の面とを有する、第1の終板と、
第2の終板であって、第2の椎体と実質的に係合するように構成される第1の面と、前記第2の終板の相対的運動を可能にするように構成される関節接合面を含む第2の面とを有する、第2の終板と、
第1及び第2の端を有する第1の細長部分、ならびに第1及び第2の端を有する第2の細長部分を備える少なくとも1つの安定化躯体であって、前記第1の細長部分の前記第2の端及び前記第2の細長部分の前記第1の端が、互いに一体的に形成されて実質的にL字型の躯体を形成し、前記第1の細長部分の前記第1の端が、前記第1または第2の板に接合され、前記第2の細長部分の前記第2の端が、前記第1または第2の椎体に自由に係合する、少なくとも1つの安定化躯体と、を備え、
第1の構成において、前記第2の細長部分が、前記人工円板の挿入を促進するために、前記第1の細長部分に実質的に垂直であり、第2の構成において、前記第2の細長部分が、前記人工円板を前記第1または第2の椎体に固定するために、前記第1または第2の終板の前記第1の面のより近くへ圧迫される、椎間人工円板。 - 前記少なくとも1つの安定化躯体が形状記憶合金から形成される、請求項10に記載の椎間人工円板。
- 前記形状記憶合金が感温性である、請求項11に記載の椎間人工円板。
- 前記形状記憶合金が、銅−アルミニウム−ニッケル合金またはニッケル−チタン合金である、請求項12に記載の椎間人工円板。
- 前記第2の構成において、前記第2の細長部分が、前記第1の細長部分に対して90°未満の角度である、請求項10に記載の椎間人工円板。
- 前記第2の構成において、前記角度が約45〜80°の範囲にわたる、請求項14に記載の椎間人工円板。
- 前記第2の細長部分の遠位端が尖っている、請求項10に記載の椎間人工円板。
- 前記第2の細長部分の一部分が鋸歯状である、請求項10に記載の椎間人工円板。
- 前記第1及び第2の終板の前記第1の面が滑らかである、請求項10に記載の椎間人工円板。
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JP2006517458A (ja) * | 2003-02-12 | 2006-07-27 | エスディージーアイ・ホールディングス・インコーポレーテッド | 人工関節円板器官及び脊椎すべり症の治療法 |
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JP2006517458A (ja) * | 2003-02-12 | 2006-07-27 | エスディージーアイ・ホールディングス・インコーポレーテッド | 人工関節円板器官及び脊椎すべり症の治療法 |
US8167948B2 (en) * | 2003-07-31 | 2012-05-01 | Globus Medical, Inc. | Anterior prosthetic spinal disc replacement |
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JP2008513173A (ja) * | 2004-09-23 | 2008-05-01 | スパイン ソルーションズ インコーポレイテッド | 椎間腔を準備するための試験用インプラント、装置およびその方法 |
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