JP2020192360A - 骨ねじ及びインプラント送出装置 - Google Patents
骨ねじ及びインプラント送出装置 Download PDFInfo
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- 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8875—Screwdrivers, spanners or wrenches
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- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
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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
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
- A61B17/7064—Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
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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
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
- A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
- A61B17/7082—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws
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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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8875—Screwdrivers, spanners or wrenches
- A61B17/8894—Screwdrivers, spanners or wrenches holding the implant into or through which the screw is to be inserted
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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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- 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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- 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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- A61F2/447—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 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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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
- A61F2/02—Prostheses implantable into the body
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- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
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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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8665—Nuts
- A61B2017/867—Nuts with integral locking or clamping means
- A61B2017/8675—Nuts with integral locking or clamping means clamping effect due to tapering, e.g. conical thread
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
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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
- 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
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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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
- 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
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- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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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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- 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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- 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
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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
Description
本出願は、「Bone screw and Implant delivery device(骨ねじ及びインプラント送出装置)」と題する2015年5月11日出願の米国特許出願第14/709,433号の優先権を主張し、参照により本明細書に援用する。
すなわち、チゼル960と案内ツール904を第1の椎間関節に配置すると、チゼル960を取り出してプレースホールドチゼル974と置き換えることが可能であり、案内ツール904の爪934がシステム900の位置を保持する。プレースホールドチゼル974が適切に配置されると、案内ツール904も取り出してチゼル960で再組立てすることも可能である。案内ツール904とチゼル960は、次に対側の椎間関節又は第2の関節内に挿入可能である。第1の関節のチゼル960をプレースホールドチゼル974で置き換えることで、第2の関節内のチゼル960と案内ツール904の位置を、側方X線透視法を利用してより簡単に確認可能とし得る。すなわち、放射線不透過のチゼル又は送出装置が第1の関節内に放置されていると、対側の椎間関節のX線像は相対的に遮蔽される可能性がある。案内ツール904を第2の椎間関節内に適切に配置した後、上記の手順が継続され得る。第2の椎間関節の処置が完了すると、まだ第1の椎間関節内にあって位置を確保しているプレースホールドチゼル974を案内ツール904が覆ってもよい。そうして次に第1の椎間関節が上記の手順で処置できる。最初の案内ツール904の配置は、チゼル960よりもむしろプレースホールドチゼル974で行って、チゼル960の置き換えを回避することも可能である。
Claims (27)
- 椎骨と隣接する椎骨の間の関節内でインプラントの固定を助けるために患者の脊柱の椎骨に骨ねじを移植するためのシステムであって、
骨ねじと、
前記骨ねじに取り外し可能に接続された骨ねじ送出機構と、
近位端、遠位端、骨ねじ、及び骨ねじ送出機構を受けるように構成された内管、及び前記近位端よりも前記遠位端の近くに配置された少なくとも1つの湾曲部、からなる案内チューブと、
を備え、
前記案内チューブの前記少なくとも1つの湾曲部は、前記内管を通って前進する前記骨ねじと前記骨ねじ送出機構の軌道を、前記案内チューブの長手軸に沿う第1の軌道から前記長手軸に対して角度を有する第2の軌道へ変更するように構成され、かつ
前記第2の軌道は、前記案内チューブの遠位端から出て前記椎骨内に入る前記骨ねじを所望の角度に配向させて前記インプラントの固定を助けるように構成されている、システム。 - 前記関節は椎間関節を含み、前記インプラントは椎間関節インプラントを含み、かつ前記骨ねじと前記骨ねじ送出機構と前記案内チューブは、前記椎間関節インプラント内の開口を通して前記椎骨内へ前記骨ねじを前進させるように構成されている、請求項1に記載のシステム。
- 前記案内チューブ内の前記湾曲部は、前記システムのユーザの補助なしで、前記軌道を前記第1の軌道から前記第2の軌道へ自動的に変更するように構成されている、請求項1に記載のシステム。
- 前記骨ねじ送出機構は、破断可能接合部において前記骨ねじ送出機構を前記骨ねじから破断分離することにより前記骨ねじから取り外し可能である、請求項1に記載のシステム。
- 前記骨ねじ送出機構に所定の大きさの力がかけられて前記破断可能接合部に破断が発生すると、前記骨ねじ送出機構は前記骨ねじから破断分離する、請求項4に記載のシステム。
- 前記骨ねじ送出機構には、前記案内チューブの前記湾曲部を通って前記送出機構を前進させるときに曲がるようになった可撓領域が含まれる、請求項1に記載のシステム。
- 前記骨ねじが前記椎骨と係合しかつ前記可撓領域が曲げられているとき、前記骨ねじと前記骨ねじ送出機構との間の破断可能接合部に荷重が集中する、請求項6に記載のシステム。
- 前記破断可能接合部が所定の荷重を受けると、前記骨ねじ送出機構が前記骨ねじから外れる、請求項7に記載のシステム。
- 前記骨ねじと前記骨ねじ送出機構は、前記骨ねじと前記骨ねじ送出機構の間に破断可能部分を有する一体装置で構成され、かつ前記骨ねじが前記破断可能部分において前記骨ねじ送出機構から破断分離すると、前記骨ねじは前記骨ねじ送出機構から外れる、請求項1に記載のシステム。
- 前記第2の軌道は、前記案内チューブの前記長手軸に対して15度から55度の間の角度をなす、請求項1に記載のシステム。
- 前記関節内に前記インプラントを移植するための、遠位端と近位端と内管とを備える細長のインプラント送出装置をさらに備え、前記案内チューブは前記インプラント送出装置の前記内管の内壁に取付けられて、前記案内チューブの前記遠位端が前記インプラント送出装置の前記遠位端又はその近くに配置されようになっている、請求項1に記載のシステム。
- 前記骨ねじ送出機構は、細長シャフトと前記細長シャフトの近位端に接続されたハンドルとを備える、請求項1に記載のシステム。
- 隣接する2つの椎骨により形成される関節内に椎骨インプラントを固定するための装置であって、
長手軸に沿って近位端から遠位端まで延伸する、細長の骨ねじ送出機構と、
前記骨ねじ送出機構の前記遠位端に取り外し可能に接続された骨ねじと、
を備える、装置。 - 前記骨ねじ送出機構と前記骨ねじの間に破断可能接合部をさらに備え、前記骨ねじ送出機構は前記破断可能接合部において前記骨ねじ送出機構を前記骨ねじから破断分離することにより前記骨ねじから取り外し可能である、請求項13に記載の装置。
- 前記骨ねじ送出機構に所定の大きさの力がかけられて前記破断可能接合部での破断が発生すると、前記骨ねじ送出機構は前記骨ねじから破断分離する、請求項14に記載の装置。
- 前記骨ねじ送出機構は可撓領域を含む、請求項15に記載の装置。
- 前記骨ねじは、ねじヘッドから延伸するシャフトを備え、前記ねじヘッドは前記送出機構の前記遠位端と一体的に形成されている、請求項13に記載の装置。
- 前記シャフトは前記ねじヘッドから前記長手軸に沿って延伸する、請求項17に記載の装置。
- 前記骨ねじと前記骨ねじ送出機構は、前記骨ねじと前記骨ねじ送出機構の間に破断可能部分を有する一体装置で構成される、請求項13に記載の装置。
- 椎間関節インプラントを椎骨に固定するためのシステムであって、
一体の骨ねじ装置であって、
近位細長シャフト部分と、
遠位骨ねじ部分と、
前記遠位骨ねじ部分を前記椎骨内へねじ込むときに前記骨ねじ装置に十分な大きさの力が掛かると破断するように構成された、前記近位細長シャフト部分の遠位端と前記遠位骨ねじ部分の近位端との間の破断可能接合部と、
を備える一体の骨ねじ装置と、
近位端と遠位端と前記骨ねじ装置を受けるように構成された内管と、前記近位端よりも前記遠位端の近くに配置された湾曲部とを備える案内チューブと、
を備え、
前記案内チューブの前記湾曲部は、前記内管を通って前進する前記骨ねじ装置の軌道を、前記案内チューブの長手軸に沿う第1の軌道から前記長手軸に対して角度を有する第2の軌道へ変更するように構成され、かつ
前記第2の軌道は、前記案内チューブの遠位端から出て前記椎骨内に入る前記遠位骨ねじ部分を所望の角度に配向させるように構成された、システム。 - 前記第2の軌道は、前記椎間関節インプラントの開口を通って前記椎骨内へ前記遠位骨ねじ部分を配向させるように構成された、請求項20に記載のシステム。
- 前記近位細長シャフト部分には、前記骨ねじ装置が前記案内チューブの前記湾曲部を通って前進させられるときに曲がるようになった可撓領域が含まれる、請求項20に記載のシステム。
- 前記遠位骨ねじ部分が前記椎骨に係合され、かつ前記可撓領域が曲がっているとき、荷重が破断可能接合部に集中される、請求項22に記載のシステム。
- 前記破断可能接合部が所定の荷重を受けると、前記遠位骨ねじ部分は前記破断可能接合部において前記近位細長シャフト部分から破断分離する、請求項23に記載のシステム。
- 前記第2の軌道は、前記案内チューブの前記長手軸に対して15度から55度の間の角度をなす、請求項20に記載のシステム。
- 前記椎骨と隣接する椎骨によって形成される椎間関節内に前記椎間関節インプラントを移植するための、遠位端と近位端と内管とを備える細長のインプラント送出装置をさらに備え、
前記案内チューブは前記インプラント送出装置の前記内管の内壁に取付けられて、前記案内チューブの前記遠位端が前記インプラント送出装置の前記遠位端又はその近くに配置されるようになった、請求項20に記載のシステム。 - 前記骨ねじ装置は、前記近位細長シャフト部分の近位端に連結されたハンドルをさらに備える、請求項20に記載のシステム。
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US10874447B2 (en) | 2020-12-29 |
EP3294166A1 (en) | 2018-03-21 |
HK1252569A1 (zh) | 2019-05-31 |
AU2016262505B2 (en) | 2021-03-11 |
JP2018515243A (ja) | 2018-06-14 |
CN107847249A (zh) | 2018-03-27 |
KR20180028407A (ko) | 2018-03-16 |
EP3294166A4 (en) | 2019-03-06 |
US20190209227A1 (en) | 2019-07-11 |
AU2016262505A1 (en) | 2017-12-07 |
JP6831798B2 (ja) | 2021-02-17 |
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