JP3955883B2 - 伸縮式椎体プロテーゼ - Google Patents

伸縮式椎体プロテーゼ Download PDF

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Publication number
JP3955883B2
JP3955883B2 JP54333998A JP54333998A JP3955883B2 JP 3955883 B2 JP3955883 B2 JP 3955883B2 JP 54333998 A JP54333998 A JP 54333998A JP 54333998 A JP54333998 A JP 54333998A JP 3955883 B2 JP3955883 B2 JP 3955883B2
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Japan
Prior art keywords
hollow body
characterized
spring
outer
inner
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Expired - Lifetime
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JP54333998A
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JP2001518824A (ja
Inventor
フリドリン スクラプフェル
マヌエル スシャール
アレックス ハテバー
Original Assignee
ジンテーズ ゲゼルシャフト ミト ベシュレンクテル ハフツング
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Priority to PCT/CH1997/000151 priority Critical patent/WO1998046173A1/de
Publication of JP2001518824A publication Critical patent/JP2001518824A/ja
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    • A61F2/00Filters 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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Description

本発明は、請求の範囲の請求項1の前文に基づき人間の脊柱の椎体を代替させるための装置に関するものである。
椎体が疾患しているか、あるいは支障をきたしている場合、椎体を脊柱から除去しなければならない。従来の技術では、欠けている椎体を代替させるための、間隔を維持する幾つかのインプラントが知られている。インプラントは、相互に摺動可能な部品(該部品は、とりわけ鋸歯状突起によってインプラントの長さを調整することが出来る)、そして2つの特殊な末端プレート(該末端プレートは、隣接する無傷の椎体に固定するのに用いられるが)を含んでいる。このような椎体プロテーゼ、あるいはインプラントは、例えばATR 24426 RASHEED、あるいはDE 196 04 246 A1 JEANSONによって知られている。
公知の椎体プロテーゼの短所は、相互に摺動可能な2つの部品が、閉じた中空シリンダではないこと、従って椎体プロテーゼ全体が低い剛性を呈していることである。
本発明の課題は、椎体を除去したにも拘わらず、安定した、かつ長さ調節の可能な椎体プロテーゼによって脊柱の持つ生体力学的、および生理学的な特性を維持することである。これと並んで、手術の経過中での脊柱インプラントの操作性も大いに重要である。
本発明は、請求の範囲の請求項1の特徴を呈する装置によって上記の課題を解決している。
本発明に基づく装置の1つの実施態様は、組み合わさるように押し入れることの出来る2つの中空シリンダを含んでいる。内側中空シリンダには、その外周部に鋸歯状突起が設けられている。外側中空シリンダは、少なくとも1つの弾性要素を呈し、該弾性要素は、内側中空シリンダの鋸歯状突起と噛み合い、そして装置の長さを決定する。鋸歯状突起と固定可能な弾性要素によって、本発明に基づく装置を延長させることができ、そして手術の際に所定の長さに適合させることが出来る。
本発明に基づく装置の別の実施態様は、互いに同軸状に配置され、かつその軸に沿って相互に摺動させることの出来る2つの中空体、外側中空体に設けた溝に取付けたばね、および該装置を隣接する椎体に固定するのに用いる末端プレートを含んでいる。内側中空体は、その外被面に鋸歯状突起を備えている。該ばねは、その内面に鋸歯状突起を呈し、該鋸歯状突起は、内側中空体の鋸歯状突起と噛み合わせた際に内側中空体を軸方向に固定する。該ばねは、外部から外側中空体の開口部を通じて補助道具を用いても広げることが出来、そして鋸歯状突起から外すことが出来るので、本発明に基づく装置のこの変形の制御された圧縮は必要があれば現場でも可能である。組み合わさるように押し入れることの出来る3つの中空体を有する実施態様も可能であって、その際に外側と内側の各シリンダ面は、それぞれ既に述べた2分割式の変形と同様に形成されている。
本発明のこの変形によって得られた利点は、基本的には、インプラントの長さを固定するための鋸歯状突起を有するばねが本発明に基づく装置に組み込まれていることにある。これによって該インプラントの構造高さを小さくすることが出来、そして隣接する椎体間の自由なスペースが小さい場合に該インプラントを使用できるのであって、このことは頸部脊柱の近傍においても該プロテーゼの使用を可能にする。ばねを広げることによって、本発明に基づく椎体プロテーゼを再び圧縮したり、除去することが可能である。その他に両方の中空シリンダは比較的肉厚が大きくても良く、そのために非常に安定したプロテーゼを形成できる。
以下において複数の実施例の一部模式図をもとにして本発明と本発明の実施態様をさらに詳しく説明することにする。
図1は、本発明に基づく装置の内側中空体1の縦断面図を;
図2は、本発明に基づく装置の1つの変形の外側中空体2の縦断面図を;
図3は、本発明に基づく装置の別の実施態様の縦断面図を;
図4は、本発明に基づく装置の1つ実施態様によるリング状ばね13の透視図を;
図5は、本発明に基づく装置の1つ実施態様による外側中空体の一部とともにリング状ばね(13)の透視図を;
図6は、本発明に基づく装置の1つ実施態様による弾性ストラップ24と両方の中空体1、2の透視図を;
図7は、本発明に基づく装置の内側中空体1の別の実施態様を
それぞれ示している。
図1は、本発明に基づく装置の1つ実施態様による内側中空シリンダ1を示している。外被面上にある鋸歯状突起5は、内側中空シリンダの長さの一部にわたってしか設けられていない。本発明に基づく装置の実施態様に応じて内側中空シリンダ1の、鋸歯状突起5の付いていない部分には、放射方向の貫通開口部30が設けられている。
図2に示した外側中空シリンダ2は、弾性要素7として複数のタブ19を呈している本発明に基づく装置の実施態様に相当し、該タブは外側中空シリンダ2の壁6から切り抜かれていて、そして中央軸3の方に向けて曲げられている。本発明に基づく装置の実施態様に応じて、外側中空シリンダ2には放射方向の貫通開口部30が設けられている。
図3に示した、本発明に基づく装置の変形は、外側中空体2を示していて、該外側中空体には、内側に中心軸3と同軸状に円筒状穴10、同じく円筒状溝12および該溝12から外側中空体2の外側表面へと貫通している開口部17が設けられている。外側中空体2内には、内側中空体1が中心軸3に沿って該外側中空体に対してスライドできるように配置されていて、該内側中空体はその外面に鋸歯状突起部5を備えている。溝12には、内側中空体1の鋸歯状突起5と形状噛み合いする鋸歯状突起14を内側に備えているばね13が挿入されている。外側中空要素2の開口部17を通じてばね13の間隙18に差し込むことの出来る補助手段によってばね13を広げると、外側中空体に対して内側中空体1を両方向にスライドさせることが出来る。
本発明に基づく装置の、図3に示した別の変形には、溝12の範囲において外側中空体2を放射方向に貫通している、両方の中空体1、2を中空軸3の方向に固定するための固定ボルト35が設けられている。
同じく図3には、本発明に基づく装置の変形が示されていて、該変形では中空体1、2の両方の自由端部36、37に端部プレート38、39が設けられていて、該端部プレートは、骨側にスパイク40を呈することが出来る。
本発明に基づく装置の図3に示した実施態様のリング状ばね13は、図4に示されている。間隙18によって該ばね13は円周部で開かれている。内側中空体1の外周部の鋸歯状突起5と噛み合うことの出来る鋸歯状突起14が、リング状ばね13の内面に設けられている。
図5は、本発明に基づく装置の図3に示した実施態様とは異なる別の実施態様を示している。ピン21が、外側中空体2に放射方向に貫入している開口部23に挿入されていて、該ピンはばね13の上端面20上の切欠き22と噛み合い、そしてばね13が中心軸3を中心にして回転するのを防止している。
図6は、本発明に基づく装置の別の実施例を示している。外側に向かって湾曲された自由端部25、26(該自由端部は、外側中空体2の長手スリット27と噛み合うことが出来るが)を有する弾性ストラップ24が、両方の中空体1、2の回転を防止している。
本発明に基づく装置の図3に示した実施態様と異なる、図7に示した別の実施態様では、内側中空体1はその下端部16において段部28を有していて、該段部の外径は拡げられていないばね13の内径よりも大きい。下端部16の該段部28は、内側中空体1が上に向かってスライドしてばね13を通過して、外側中空体2から滑り出してしまうのを防止している。
本発明の更なる好ましい態様として、前記中空体(1、2)の一方、あるいは両方は、前記中心軸(3)に沿ってオフセットされていることを特徴とする椎骨を代替するための装置。
また、両方の前記中空体(1、2)は、非円形断面を有していることを特徴とする椎骨を代替するための装置。
さらに、前記鋸歯状突起(5;14)は、前記内側中空体(1)にも、また前記ばね(13)にも圧縮荷重のかかる側で前記上端部(37)の方向にアンダーカットされていることを特徴とする椎骨を代替するための装置。

Claims (14)

  1. 内側中空体(1)と外側中空体(2)を含む、椎骨を代替するための装置であって、
    該内側中空体と外側中空体は、中心軸(3)に沿って同軸状に組み合わさるように押し入れることが出来、そして該中心軸(3)の方向において互いに相対的に摺動でき、そして内側中空体(1)はその外面に(4)鋸歯状突起(5)を呈しているところの装置において、
    A)該外側中空体(2)は、中心軸(3)に沿って貫通している穴(10)を呈すること;
    B)該外側中空体(2)は、少なくとも1つの弾性要素(7)を呈していて、該弾性要素は、穴(10)内に突き出ていて、そして該穴(10)の直径を、該弾性要素(7)が前記内側中空体(1)の鋸歯状突起(5)に噛み合うように減少させていること、そして
    C)前記内側中空体(1)は、剛性が高い
    ことを特徴とする前記装置。
  2. 前記両方の中空体(1、2)は、中空円筒状であることを特徴とする請求項1に記載の装置。
  3. 少なくとも1つの前記弾性要素(7)は、タブ(19)として前記外側中空体(2)の壁(6)から切り取られていることを特徴とする請求項1あるいは2に記載の装置。
  4. 前記弾性要素(7)として放射方向に間隙(18)によって開かれたリング状ばね(13)であって、該ばねはその内周部(15)に鋸歯状突起(14)を備えていて、そして前記外側中空体(2)の内面(11)を周回している溝(12)に取付けられており、前記内側中空体(1)の前記鋸歯状突起(5)と噛み合うことを特徴とする請求項1あるいは2記載の装置。
  5. 前記外側中空体(2)を通じて放射方向に貫通している開口部(17)によって前記ばね(13)は、該開口部(17)を通じて前記ばね(13)の間隙(18)内に挿入できる補助手段を用いて広げることが出来、そしてそれによって前記ばね(13)の前記鋸歯状突起(14)を前記内側中空体(1)の前記鋸歯状突起(5)から外すことが出来ることを特徴とする請求項4に記載の装置。
  6. 前記ばね(13)は、端面(20)上で切欠き(22)を呈していることを特徴とする請求項4あるいは5に記載の装置。
  7. ピン(21)が、前記外側中空体(2)に貫入している開口部(23)に挿入されていること、そして該ピン(21)は、前記切欠き(22)との形状噛み合いによって前記中心軸(3)を中心とする前記ばね(13)の回転を防止していることを特徴とする請求項4から6のいずれか1項に記載の装置。
  8. ストラップ(24)は、外側に湾曲された自由端部(25、26)とともに前記外側中空体(2)の長手スリット(27)と噛み合わせることが出来、そして該ストラップは、両方の前記中空体(1、2)の回転を防止していることを特徴とする請求項1から7のいずれか1項に記載の装置。
  9. 前記内側中空体(1)は、その下端部(16)で段部(28)を呈していて、該段部の外径は、拡げられてないばね(13)の内径よりも大きく、そして該段部は、前記内側中空体(1)が上に向かってスライドして該ばね(13)を通過して前記外側中空体(2)から滑り出してしまうのを防止していることを特徴とする請求項4から8いずれか1項に記載の装置。
  10. 両方の前記中空体(1、2)は、前記中心軸(3)に対して放射方向に貫通開口部(30)を呈していることを特徴とする請求項1から9のいずれか1項に記載の装置。
  11. 前記溝(12)とばね(13)は、接触面(31)に向かって狭まるようにテーパ状に形成されていることを特徴とする請求項4から10のいずれか1項に記載の装置。
  12. 両方の前記中空体(1、2)の両方の自由端部(36、37)に末端プレート(38、39)が取付けられていることを特徴とする請求項1から11のいずれか1項に記載の装置。
  13. 前記末端プレート(38、39)の骨側にスパイク(40)が取付けられていることを特徴とする請求項12に記載の装置。
  14. 前記外側中空体(2)に固定ネジ(35)がねじ込まれていることを特徴とする請求項1から13のいずれか1項に記載の装置。
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AU723279B2 (en) 2000-08-24
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