JP2889696B2 - 椎間板用人工装具及びその移植用器具 - Google Patents
椎間板用人工装具及びその移植用器具Info
- Publication number
- JP2889696B2 JP2889696B2 JP3505780A JP50578091A JP2889696B2 JP 2889696 B2 JP2889696 B2 JP 2889696B2 JP 3505780 A JP3505780 A JP 3505780A JP 50578091 A JP50578091 A JP 50578091A JP 2889696 B2 JP2889696 B2 JP 2889696B2
- Authority
- JP
- Japan
- Prior art keywords
- prosthesis
- flat plate
- plate
- base
- joint
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- 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
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
-
- 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
- A61F2/4611—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 of spinal prostheses
-
- 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
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0256—Joint distractors for the spine
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
- A61F2002/30649—Ball-and-socket joints
- A61F2002/30662—Ball-and-socket joints with rotation-limiting means
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30795—Blind bores, e.g. of circular cross-section
- A61F2002/30797—Blind bores, e.g. of circular cross-section internally-threaded
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30795—Blind bores, e.g. of circular cross-section
- A61F2002/30807—Plurality of blind bores
- A61F2002/30808—Plurality of blind bores parallel
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
- A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
- A61F2002/30891—Plurality of protrusions
- A61F2002/30892—Plurality of protrusions parallel
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30904—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves serrated profile, i.e. saw-toothed
-
- 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
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
- A61F2002/443—Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
-
- 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
- A61F2002/4622—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 having the shape of a forceps or a clamp
-
- 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
- A61F2002/4628—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 an axis transverse to the instrument axis or to the implantation direction, e.g. clamping
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T403/00—Joints and connections
- Y10T403/32—Articulated members
- Y10T403/32549—Articulated members including limit means
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Transplantation (AREA)
- Neurology (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
Description
板を置き換えるように設計された椎間(円)板用の人工
装具及びその移植用器具に関する。
摩耗してしまうことは公知である。この結果、多くの病
状が生じ、患者に激しい痛みや不安を与えてしまうので
ある。
めに介入し得たことは、不完全な円板または椎骨間の骨
癒合を単に切断したりすることであったが、これだけで
は一時的に患者を楽にするだけであってしかも同時に患
者に確実な機能的身体的障害を与えてしまっていた。こ
の20年にわたり、全体または部分的に切除した椎間板を
置き換えるために設計された人工装具に、多少は成功裏
に依存してきた。
1つの方法は、仏国特許第2,372,622号に記載されたよ
うな、球状くぼみを有する2つの対応する板の間に配置
された延性のある、圧縮できない材料でできた膝頭型の
円板で不完全な円板を取り替えることである。もう1つ
の方法は、仏国特許第2,124,815号に記載されたよう
な、本来の円板と殆ど同一の機械的特性を備えた複合材
料でできた人工円板、即ち繊維材料で強化されたエラス
トマーでできた円板で不完全な円板を取り替えることで
ある。
て,欧州特許出願第0,042,271号に記載されたような、
各々半球状パッドと半球状くぼみを有し、一方の部分は
金属で他の部分は合成物(ポリエチレン、ポリメタクリ
レートなど)である2部分式人工装具を主目的とする人
工装具を製造した。
14mm)を修復し且つ経時で保持し易く、これらを所望す
るだけ反対方向に離して保持するが、当該椎骨の相対的
な動きのため人工装具が段々一列に並ばなくなってしま
い、病状が現れ、外科的な介入が必要となってしまうの
である。この問題を解決するために、人工装具が位置に
挿入され得るように椎骨を十分に離しておくために、外
科医が最初に与えた分離力を弱めるとすぐに、各椎骨に
移植されるように設計された小さなクランプを圧力板の
外側に備えた特定の円板様人工装具が提供されてきた。
しかしながら、この外側の接合方法は、椎骨が平行に残
っているときのみに有効であり、従って脊柱は湾曲しに
くい。この反対の場合にはこのようなことは起きないこ
とは容易に理解し得る。というのもこれらが反対側から
外れるとき、クランプが湾曲部の一方の側のこれらのく
ぼみ内に支持されたまま残るからである。このため、湾
曲部がある回転を伴うとき、くぼみは段々ぐらついてし
まう。従って、人工装具は段々その理想的な位置から外
れてしまい、最後には排出され、大変な問題をもたらす
のである。
に対し特定の感度を伴う柔軟性と靱性の特徴を調和させ
るのは難しい。椎間板用人工装具の製造は、このように
基部の反対に大きな半径の2つの球形キャップから構成
される2重の膝頭接合部を導入することができる3部式
ユニットに大きく依存してきた。
することを許容するけれども、特に脊柱が当該椎骨の近
くで曲がるとき、突き出しによって、2重の膝頭接合部
の厚さを実質的に減少させてしまい、接合部を脱臼させ
易くしてしまうという欠点がある。何故なら、この引き
付ける力は湾曲方向に2重の膝頭接合部の締め付けに転
換されるので、他方向での分離を目立たせてしまうから
である。
る。本発明は、特徴付けられるように、一方では2つの
椎骨の相対匂配がどんなであろうと、当該椎骨の相対的
な縦及び横の逃げ角を制御する間、下部椎骨にかかる上
部椎骨の推力が摩耗に対し良好な耐性を提供し且つユニ
ットに特定の柔軟性を与える大きな支持面を備えた素子
を介して伝搬される際に椎間板の人工装具が起こす問題
を解決する。人工装具の上部及び下部部分は、これらが
分離するどんな危険性も避けるようにこれらの個々の椎
骨平板中に十分に固定される。この操作は、椎骨を脆く
することなく実施され且つ容易に使用される簡単な器具
を使用し得る。
っかり差し込まれた円筒状基部を備える球状キャップか
らなるジョイント部分によって隔てられている。固定フ
ラップを各々備える2つの平板から構成されること、及
び各平板は、円筒状キャビティの背面の両側に対称的に
且つ固定フラップに対し平行に配置されているねじ穴を
有すること によって特徴付けられる。
及び下部平板の外周上に各々配置されている相補的部分
を持つ2つの2段フランジによってα値に限定されてい
る。
ビティの端と前記平板の端との間に位置している全体部
分を占め、上部平板の2段フランジはジョイント領域を
確保する半球状キャビティの端と前記平板の端との間に
位置している全体部分を占める。
(D)及び上部及び下部の2段フランジの幾何学的な特
徴は、前記フランジが互いに重なるときに、平板の最大
の相対的なピッチ角αが2つの椎骨の間に元から存在す
る角度、即ち約15°に対応するように決定される。
βで前記平板の基部の方に傾斜している環状面と、半球
状キャビティの端から平板基部に対して約70°の角度δ
を形成するもう1つの環状面との結合から形成されてい
る。
約20°の角度θで高くなっている環状面と、円筒状キャ
ビティの端から平板の基部に対して約60°の角度γを形
成するもう1つの環状面との結合から形成されている。
イントの直径(D)よりも小さい直径(d)の柔軟材料
で作られているワッシャによってその移植キャビティの
底で支持されている。前記ジョイントはポリエチレン製
で、平板はチタンまたはチタン合金製で、椎骨との接触
面は骨合成し易いようにプラズマ処理されている。
端には『鋸歯』型のレリーフがあり、歯の上端は、フラ
ップがそのほぞ穴に導入される方向の正面に向かって傾
斜している。
厚さ(E)よりもやや小さい。
の椎骨列及びほぞ穴ゲージ、 ほぞ穴を形成するための骨切り用ノミ、 ビルト−インタイプの衝撃−吸収板を備えた人工装具用
衝撃チップ、 ゲージ、人工装具インパクタ及び骨切り用ノミを操作す
るための工具、 人工装具を配置するためのクランプ、及び 人工装具エクストラクタ を備えることを特徴とする。
の中央の縦面に配置されたゲージとインパクタロッドの
ねじ切り端部と同一サイズの後方から正面へのねじ切り
のダミー穴とを有する対応する人口装具平板と同一形及
び空間条件を備えた適切な厚さの平板と、2つは他方の
反対にあり、各平板から固定フラップを隔たせる距離に
ちょうど対応する距離で中央の縦面のいずれかの側に対
象的にその2つが他の2つと向かい合って配置された4
つの溝から構成されている。溝の長さは、各平板を固定
し且つ正確に配置するのにちょうど十分な深さに骨切り
用ノミの貫通を制限するように決定されている。前記ノ
ミは、溝の長さに対応する深さにその縦方向の貫通を制
限するヒールを有する。
形に合致するねじと逆になっており、他方は堅い材料で
作成された衝撃・吸収板が備えられている、柔軟材料で
作成された平行六面体様の形のねじ切り素子から構成さ
れている。
する工具は、金属性のロッドから主に構成されており、
その一端は溝ゲージ、衝撃チップ及び骨切り用ノミのヒ
ールのねじ穴の寸法に合わせてねじ切られており、他端
はタペットによって固定される格納式のスリーブ上の半
球状のスロートが前方にある駆動スクエアを有し、これ
は長円形のハウジング中の可動性の円筒状のキーを備え
た固定及び解除用ばねによって外側に押し出されてい
る。固定及び解除は、タペット中に作成された種々の深
さの2つの接線溝によって実施される。
ているハンドルから構成されており、各ハンドルは、そ
の目的のために平板に設けられた穴の内側に貫通するよ
うに設計された2つのロッドを含む、人工装具の平板の
形を形取るチップを備えている。
と集合的操作平板内に滑り込むように据え付けられたね
じ切り端部とを備える4つの平行ロッドから構成されて
おり、人工装具の平板のねじ穴内のロッドのねじ切り端
部の据え付けゲージ及び分解用の衝撃ボデーとしても役
立つ。
て平板が各々固定され、 骨との接触面が増加し、ほぞ穴が椎骨の後部皮質を横切
らないので後方への排出が阻止され且つフラップが溝の
底に差し込まれたその端の上に適当な形の歯を有するの
で前方への排出が阻止され、 プラズマ処理により強化された平板の金属(チタン)と
確実に骨合成でき、 止めを形成する2段フランジによって動きが約15°に制
限され、並びに 下部平板ジョイントを差し込む方法により、 その理想位置で、変位または早過ぎる脱臼の危険なく一
定保持されていることである。
おいて間違った解釈または不良処置を許容することな
く、簡単な装置を使用して移植される。
により作成された人工装具を配置するための器具に関す
る以下の記載並びに添付図面を参照とする非限定的な態
様から明らかになろう。
配置された、人工装具の縦断面の正面図を示す。
配置された、人工装具の側面図を示す。
す。
いる据え付け及びほぞ穴用ゲージの平面図を示す。
いる据え付け及びほぞ穴用ゲージの側面図を示す。
いる人工装具衝撃チップの正面図を示す。
を示す。
された下部平板120の上部側に作成された同一直径
(D)の円筒状キャビティ122内に差し込まれた、円筒
状基部22と球状キャップ21で構成されるジョイント20に
よって隔てられた各固定フラップ1110,1210を各々備え
た、基本的に2つの平板110,120を含む椎間板400,410用
の人工装具100を示している。前記平板110,120は円筒状
キャビティ122及び2段フランジ113及び123の両側に対
称的に配置されたねじ穴115,116及び125,126を有する。
相補的部分は、端から約10°の角度βで傾斜したぎざぎ
ざのある環状面112と、半球状キャビティ117の端から上
部平板110の基部に対して約70°の角度δで傾斜したも
う1つの環状面114との結合と、下部平板120の基部に関
し約20°の角度θの環状面124と、円筒状キャビティ122
の端から下部平板120の基部に関し約60°の角度γを形
成するもう1つの環状面127との結合から構成されてい
る。
つその端には『鋸歯』型のレリーフ1111及び1211を有す
る。その歯は、以下に記載されるゲージ50を使用して椎
骨400,410に骨切り用ノミ90を使用して前以て作成され
たほぞ穴401及び411中に導入される方向に、正面に向か
って傾斜している。
ている本発明の列及びほぞ穴ゲージ50は、人工装具100
の平板110及び120と同一厚さ、同一形及び同一空間条件
の平板から構成されており、且つ正面近くに丸い隅51
と、後方から正面には配置工具のロッド70のねじ切り端
部71に接合させるように設計されているねじ切りしたダ
ミー穴52を有する。前記ゲージは、平板110及び120から
固定フラップ1110及び1210を隔てる距離に相当する距離
だけ離れている4つの溝53,54,55,56を有する。溝53,5
4,55,56の長さは、平板110,120を各々正確に固定するた
めにちょうど十分な深さだけ骨切り用ノミ90の貫通を制
限するように決定される。前記ノミ90の刃91は、その端
が椎骨の後方皮質に主として対応しなければならない溝
53,54,55,56の長さにその貫通を制限するヒール92を持
っている。
プ60は、柔軟材料で作成された平行六面体の形をした素
子によって主として構成されており、その一端61は平板
110,120の外側の端の形と合致し、その他方の端はねじ
穴62が備えられており、工具のロッド70の端71がねじ込
まれるようになっていて、堅い材料で作成された衝撃−
吸収板63も備えられている。
ンパクタチップ60及び骨切り用ノミ90を操作するための
工具は、その一端71がねじ穴52及び62、ゲージ50並びに
衝撃チップ60の寸法に合わせてねじ切られている金属製
ロッド70から主に構成される。
ッド上に作成された半球状スロート73によってロッド上
に随意に適合されているスリーブ74用の駆動スクエア72
と、スリーブ74に配置されている長円形ハウジング78内
の可動性の円筒状キー77とを有する。前記キー77は、ロ
ッドのスロート73の底に固定されたボタン75によって作
動されるばね76によって外側に押し戻され得るか、前記
ボタン75の軸に圧力が与えられたかどうかによって、そ
れから完全に外され得る。種々の深さのくぼみ751及び7
52はこれを実施するためにボタン75に対して接線方向に
作成されている。スリーブ74は、その軸上のロッド70に
直接衝撃を与えるためにその上部部分上に金属製の衝撃
部分79を有する。
イヤ80は、通常ばね83によって離れている2つのハンド
ル810及び820から構成されており、ハンドルの端部は、
それぞれが、人工装具の平板110,120の形を形取り、且
つ平板内にその目的のために作成された穴115,116及び1
25,126の内側に貫通するように設計された2つのロッド
812,813及び822,823を含むチップ811,821を有する。従
って前記穴は、底から少し離してねじ穴が開けられてお
り、このねじは、以下に記載するエクストラクタと一緒
に引き出す際にのみ使用される。
クタ900は、4つのロッド910,920,930,940から構成され
ており、その一端912,922,932及び942は人工装具のねじ
穴のサイズに合わせてねじ切られており、そのもう一端
は横木及び衝撃ボデーを形成する平板950にスライドす
るように据え付けられた刻みのついたボタン911,921,93
1,941を有する。
工具のロッド70のねじ切り端部71の大きさに合わせられ
ており、その貫通を制限するヒール92を備えた刃によっ
て伸長されているねじ穴94を備えた基部93から構成され
ている。刃91は、ヒール92の反対側に向ってねじ付けさ
れている。刃の能動部分の後方95の長さ(L)は、これ
らの基部で測定したフラップ1110,1210よりもやや薄い
(E)。これはほぞ穴401,411中の装置がゲージ50及び
骨切り用ノミ90を使用して作成された後、クランプされ
得るようになっている。
は、以下の操作を順に実施することからなる。
し、 当該椎骨400,410の特有の特徴を元にして選択したゲ
ージ50を挿入できるように椎骨を分離し、 フラップ1110,1210によって椎骨400,410中に平板110,
120を固定できるように設計されているほぞ穴401,411を
作成する。このほぞ穴は、この目的のために操作する工
具のロッドのねじ切り端部71の上にねじ止めされている
骨切り用ノミ90で開けられる。前記ノミは、ねじ部分が
当該椎骨400または410に向けられ、刃のヒール92が固定
フラップ1110,1210の移植に必要な長さ以上にフラップ
を貫通させないように、溝53,54,55及び56内に順に挿入
され、前記溝の底にその後方95があたるようにその刃91
が入れられる。この長さは、フラップが椎骨の後方皮質
にあたって停止できるように決定され、人工装具が後方
への排出のいかなる危険性をも排除し得る。
れたまま保持しながら、上部及び下部のほぞ穴がすっか
り作成された後ゲージ50を引き出し、 その4つのロッド812,813及び822,823を人工装具の平
板110及び120の穴115,116及び125,126に予め導入してお
いた配置用プライヤ80を用いて、椎骨400,410の間に人
工装具を配置する。フラップ1110,1210をそのほぞ穴に
完全に挿入するのは、ハンドル820を延ばして端821をロ
ッド822,823と置き換えることによって伸長且つ形成さ
れたプライヤのハンドルの一端820に圧力または衝撃を
加えると容易である。
り、ほぞ穴401及び411の底にはフラップ1110及び1210の
歯の端1111及び1211が当たり、上部平板110の半球状キ
ャビティ117のジョイント20全体の支持を得るために椎
骨400,410に加えられていた分離作用力を外す。歯形を
考慮に入れると、このように人工装具の前方排出のいか
なる危険性も排除される。
なるであろう。これは、以下の方法によって実施され得
る。
120を緩め易くするために、椎骨400,410を通常の分離器
を使用して分離し、 刻みのついたボタン911,921,931及び941の下に平板95
0により衝撃を加えることによって、平板を緩め且つそ
のほぞ穴401,411からフラップ1110,1210を離脱させやす
いように、人工装具100の平板110及び120のねじ穴115,1
16,125,126に、接続平板950にその目的のために設けら
れた穴にロッド910,920,930及び940のねじ切り端部を入
れた後、これらねじ切り端部をねじ止めすることによっ
て人工装具エクストラクタ900を据え付ける。
に上述した方法によって配置される。
椎骨手術用に設計されている。
Claims (20)
- 【請求項1】下部平板(120)の上側に作成されたのと
同一直径を有する円筒状キャビティ(122)中に差し込
まれた円筒状基部(22)を備える球状キャップ(21)か
ら構成されるジョイント(20)によって隔てられてい
る、固定フラップ(1110,1210)を各々備える2つの平
板(110,120)から主に構成されていることと、 各平板(110,120)が円筒状キャビティ(122)の背面の
両側に対称的に且つ固定フラップ(1110,1210)に平行
に配置されているねじ穴(115,116,125,126)を有する
こと を特徴とする椎間板用の人工装具。 - 【請求項2】下部平板(120)と上部平板(110)との互
いの逃げ角が、上部平板(110)の外周及び下部平板(1
20)の外周に各々配置されている、相補的部分を持つ2
段フランジ(113,123)によって限定されていることを
特徴とする請求項1に記載の人工装具。 - 【請求項3】下部平板(120)に配置された2段フラン
ジ(123)が、ジョイント(20)の円筒状キャビティ(1
22)の端と前記平板(120)の端との間に位置している
全体部分を占めることを特徴とする請求項2に記載の人
工装具。 - 【請求項4】上部平板(110)の2段フランジ(113)
が、ジョイント(20)領域を確保する半球状キャビティ
(117)の端と前記平板(110)の端との間に位置してい
る全体部分を占めることを特徴とする請求項2に記載の
人工装具。 - 【請求項5】前記フランジ(113,123)が重なるとき、
平板(110,120)の最大の相対的なぐらつき角度αが2
つの椎骨間にもともとある角度に対応するように、ジョ
イント(20)領域を確保する円筒状キャビティ(122)
の直径(D)と上部及び下部の2段フランジ(113)(1
23)の幾何学的特徴とが決定されることを特徴とする請
求項4に記載の人工装具。 - 【請求項6】上部平板(110)の2段フランジ(113)
が、その端から約10°の角度βで前記平板(110)の基
部に向かって傾斜した環状面(112)と、半球状キャビ
ティ(117)の端から平板(110)の基部に対して約70°
の角度δを形成するもう1つの環状面(114)との結合
から構成されていることを特徴とする請求項3に記載の
人工装具。 - 【請求項7】下部平板(120)の2段フランジ(123)
が、前記平板(120)の基部に対して約20°の角度θ高
くなっている環状面(124)と、円筒状キャビティ(12
2)の端から平板(120)の基部に対して約60°の角度γ
を形成するもう1つの環状面(127)との結合から構成
されることを特徴とする請求項4に記載の人工装具。 - 【請求項8】ジョイント(20)の基部(22)が、ジョイ
ント(20)の基部(22)の直径(D)よりも小さい直径
(d)の柔軟材料(30)で作られているワッシャによっ
て円筒状キャビティ(122)の底で支持されていること
を特徴とする請求項1に記載の人工装具。 - 【請求項9】椎骨(400,410)の基部中の平板(110,12
0)の固定フラップ(1110,1210)が、ねじ止めされてい
て且つ固定フラップの端に『鋸歯』型のレリーフ(111
1,1211)を有することを特徴とする請求項1に記載の人
工装具。 - 【請求項10】フラップがそのほぞ穴(401,411)内に
挿入される方向に、正面に向かって歯の上端が傾斜して
いることを特徴とする請求項9に記載の人工装具。 - 【請求項11】その基部でのフラップ(1110,1210)の
厚さ(E)が、椎骨(400,410)に予め作成されたほぞ
穴(401,411)の厚さ(l)よりも幾らか大きいことを
特徴とする請求項1〜9のいずれか一項に記載の人工装
具。 - 【請求項12】平板(110,120)及びそのフラップ(111
0,1210)が、チタンまたはチタン合金で作成され、椎骨
と接触する全表面をプラズマ処理されていることを特徴
とする請求項1に記載の人工装具。 - 【請求項13】ジョイント(20)がポリエチレン製であ
ることを特徴とする請求項1に記載の人工装具。 - 【請求項14】椎骨を分離させ、ほぞ穴を開けるための
一組のゲージ(50)、 ほぞ穴(401,411)を作成するために設計された骨切り
用ノミ(90)、 ビルト−インタイプの衝撃−吸収板(63)を備えた人工
装具衝撃チップ(60)、、 ゲージ(50)、人工装具インパクタ(60)及び骨切り用
ノミ(90)を操作するための工具、 一組の人工装具配置用プライヤ(80)、及び 人工装具エクストラクタ(900) からなることを特徴とする、上記請求項1〜13のいずれ
か一項に記載の人工装具の移植用器具。 - 【請求項15】分離及びほぞ穴作成用ゲージ(50)は、
対応する人工装具(100)の平板(110,120)と同一の空
間条件を備えた同一形の適切な厚さの平板から構成さ
れ、 正面近くで且つ後方から正面にかけて丸い隅(51)と、 平板の中央の縦面に配置されたゲージ(50)とインパク
タ(60)を操作するための工具のロッド(70)のねじ切
り端部(71)と同一サイズのねじ切りダミー穴と、 各平板(110,120)の固定フラップ(1110,1210)を隔て
ている距離と正確に対応する距離だけ、平面の中央の縦
面の両側に対称的に配置された、その2つが他の2つと
向かい合っている4つの溝(53,54,55,56)と、 を有することを特徴とする請求項12に記載の移植器具。 - 【請求項16】溝(53,54,55,56)の長さが、骨切り用
ノミ(90)の貫通を、椎骨の後方皮質に対応する各フラ
ップ(1110,1210)を固定し且つ正確に配置するのにち
ょうど十分な深さに制限するように決定されることを特
徴とする請求項15に記載の器具。 - 【請求項17】人工装具インパクタチップ(60)が、平
行六面体の形で、柔軟材料で作成されたねじ切り素子か
ら構成されており、ねじ山(62)と反対のその一端は、
人工装具の平板(110,120)の形に従って形成されてお
り、その他端は堅い材料で作成された衝撃板(63)を備
えていることを特徴とする請求項14に記載の器具。 - 【請求項18】ゲージ、人工装具インパクタチップ及び
骨切り用ノミの操作用工具が、金属製ロッド(70)から
主に構成されており、 その一端(71)は、ほぞ穴作成用ゲージ、インパクタチ
ップ及びノミ(90)の基部(93)のねじ穴の寸法に合わ
せてねじ切られており、 その他端は、衝撃チップ(79)を備えた、スリーブ(7
4)がはまっている半球状スロート(73)が前方につい
ている駆動スクエア(72)を有しており、ばね(76)に
よって支持されたタペット(75)、ロッド(70)にスリ
ーブ(74)を接合する、長円形ハウジング(78)に押し
込められた可動性の円筒状キー(77)が備えられてお
り、半球状スロート(73)とタペット(75)に作られた
種々の深さの接線溝(751,752)とにより収縮され得る
ことを特徴とする請求項14に記載の器具。 - 【請求項19】そのハンドル(810,820)が通常、ばね
(83)によって隔てられている人工装具用の配置用プラ
イヤ(80)に人工装具(100)の平板(110,120)の形を
形取るチップ(811,821)が備えられており、各チップ
が、平板(110,120)にその目的のために設けられた穴
(115,116,125,126)の内部に貫通するように設計され
た2つのロッド(812,813及び822,823)を含むことを特
徴とする請求項14に記載の器具。 - 【請求項20】人工装具エクストラクタが、平板及び衝
撃ボデーにその目的のために設けられているねじ切り穴
に対して配置用ゲージとして作用する集合的操作板(95
0)内に開けられた穴に滑り込むように据え付けられ
た、刻みのついた操作用ボタン(911,921,931,941)及
びねじ切り端部(912,922,932,942)を備えている4つ
のロッド(910,920,930,940)から構成されていること
を特徴とする請求項14に記載の器具。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR9002997 | 1990-03-07 | ||
FR9002997A FR2659226B1 (fr) | 1990-03-07 | 1990-03-07 | Prothese pour disques intervertebraux et ses instruments d'implantation. |
Publications (2)
Publication Number | Publication Date |
---|---|
JPH04505574A JPH04505574A (ja) | 1992-10-01 |
JP2889696B2 true JP2889696B2 (ja) | 1999-05-10 |
Family
ID=9394550
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP3505780A Expired - Lifetime JP2889696B2 (ja) | 1990-03-07 | 1991-03-04 | 椎間板用人工装具及びその移植用器具 |
Country Status (10)
Country | Link |
---|---|
US (1) | US5314477A (ja) |
EP (1) | EP0471821B1 (ja) |
JP (1) | JP2889696B2 (ja) |
KR (1) | KR100189346B1 (ja) |
AT (1) | ATE106707T1 (ja) |
AU (1) | AU7499191A (ja) |
DE (1) | DE69102369T2 (ja) |
ES (1) | ES2057874T3 (ja) |
FR (1) | FR2659226B1 (ja) |
WO (1) | WO1991013598A1 (ja) |
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- 1991-03-04 WO PCT/FR1991/000173 patent/WO1991013598A1/fr active IP Right Grant
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Cited By (3)
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JP2006504501A (ja) * | 2002-10-29 | 2006-02-09 | スパインコア,インコーポレイテッド | 人工椎間板を植え込む際に使用するための器具類、方法、および機能 |
JP2009279413A (ja) * | 2002-10-29 | 2009-12-03 | Spinecore Inc | 人工椎間板を植え込む際に使用するための器具類、方法、および機能 |
JP4654125B2 (ja) * | 2002-10-29 | 2011-03-16 | スパインコア,インコーポレイテッド | 人工椎間板を植え込む際に使用するための器具類、方法、および機能 |
Also Published As
Publication number | Publication date |
---|---|
US5314477A (en) | 1994-05-24 |
KR920700595A (ko) | 1992-08-10 |
DE69102369T2 (de) | 1995-01-05 |
FR2659226B1 (fr) | 1992-05-29 |
ES2057874T3 (es) | 1994-10-16 |
ATE106707T1 (de) | 1994-06-15 |
FR2659226A1 (fr) | 1991-09-13 |
KR100189346B1 (ko) | 1999-06-01 |
EP0471821B1 (fr) | 1994-06-08 |
AU7499191A (en) | 1991-10-10 |
DE69102369D1 (de) | 1994-07-14 |
JPH04505574A (ja) | 1992-10-01 |
EP0471821A1 (fr) | 1992-02-26 |
WO1991013598A1 (fr) | 1991-09-19 |
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